Provider Demographics
NPI:1457175077
Name:JONES, DEJONET
Entity type:Individual
Prefix:
First Name:DEJONET
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 N BEACH ST APT 6303
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7061
Mailing Address - Country:US
Mailing Address - Phone:850-288-7163
Mailing Address - Fax:
Practice Address - Street 1:1652 KELLER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3877
Practice Address - Country:US
Practice Address - Phone:682-291-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician