Provider Demographics
NPI:1649697525
Name:JONES, SHAHALYNNI
Entity type:Individual
Prefix:
First Name:SHAHALYNNI
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAHALYNNI
Other - Middle Name:JONES
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP, L-SLP
Mailing Address - Street 1:7138 MAYO BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-3043
Mailing Address - Country:US
Mailing Address - Phone:504-261-9426
Mailing Address - Fax:
Practice Address - Street 1:7138 MAYO BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-3043
Practice Address - Country:US
Practice Address - Phone:504-261-9426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist