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NPI Code Detail

MEDICARE: MRS. KATHERINE LISICIA JONES MED.CCC-SLP

MEDICARE:  MRS. KATHERINE LISICIA JONES  MED.CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP001414GA

General Provider Information

NPI Number : 1639472616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE LISICIA JONES MED.CCC-SLP
Provider Business Mailing Address
First Line : 3230 NEW MAINE TRL
Second Line :
City : CUMMING
State : GA
Zip : 30041-2882
Country : US
Telephone Number : 678-513-6193
Fax Number :
Provider Business Practice Location Address
First Line : 3230 NEW MAINE TRL
Second Line :
City : CUMMING
State : GA
Zip : 30041-2882
Country : US
Telephone Number : 678-513-6193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2010
Last Update Date : 12/13/2010

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Directions to “ MRS. KATHERINE LISICIA JONES MED.CCC-SLP” Practice Location

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