Provider Demographics
NPI:1740675107
Name:JONES, ANGELA (LMFT, RPT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 EXECUTIVE CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3185
Mailing Address - Country:US
Mailing Address - Phone:478-284-6659
Mailing Address - Fax:
Practice Address - Street 1:1000 EXECUTIVE CT
Practice Address - Street 2:SUITE B
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3185
Practice Address - Country:US
Practice Address - Phone:478-284-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001389106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist