MEDICARE: MISS JALESSA J JONES

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1841631876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JALESSA J JONES

Provider Business Mailing Address
First Line	:	2840 HARRISON AVE
Second Line	:	APT 1
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7185
Country	:	US
Telephone Number	:	513-346-9596
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 HARRISON AVE
Second Line	:	APT 1
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7185
Country	:	US
Telephone Number	:	513-346-9596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	07/05/2013

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