Provider Demographics
NPI:1770021719
Name:JONES, TENEISHA
Entity type:Individual
Prefix:
First Name:TENEISHA
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 1:5115 N SOCRUM LOOP RD
Mailing Address - Street 2:APT 16
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-4288
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5115 N SOCRUM LOOP RD
Practice Address - Street 2:APT 16
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-4288
Practice Address - Country:US
Practice Address - Phone:334-208-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health