Provider Demographics
NPI:1255348298
Name:JONES, MOLLY M (PH D)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:M
Other - Last Name:JONES-QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:622 MARYLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5812
Mailing Address - Country:US
Mailing Address - Phone:202-544-8181
Mailing Address - Fax:202-546-0457
Practice Address - Street 1:622 MARYLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5812
Practice Address - Country:US
Practice Address - Phone:202-544-8181
Practice Address - Fax:202-546-0457
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1054103TC0700X
MD01454103TC0700X
VA0107-001129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
646678Medicare ID - Type Unspecified