Healthcare Provider Details

I. General information

NPI: 1033044425
Provider Name (Legal Business Name): TRISTEN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 NORTHEAST EXPY NE STE 110
ATLANTA GA
30341-5323
US

IV. Provider business mailing address

3190 NORTHEAST EXPY NE STE 110
ATLANTA GA
30341-5323
US

V. Phone/Fax

Practice location:
  • Phone: 404-467-6005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1523127
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: