Provider Demographics
NPI:1457953689
Name:JONES, TERICE K (MS)
Entity Type:Individual
Prefix:
First Name:TERICE
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 CONGRESS AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3769
Mailing Address - Country:US
Mailing Address - Phone:203-815-9245
Mailing Address - Fax:
Practice Address - Street 1:268 CONGRESS AVE APT 19
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3769
Practice Address - Country:US
Practice Address - Phone:203-815-9245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health