Healthcare Provider Details

I. General information

NPI: 1144106295
Provider Name (Legal Business Name): JASON JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 COLONEL ASHTON PL
UPPER MARLBORO MD
20772-2881
US

IV. Provider business mailing address

4741 COLONEL ASHTON PL
UPPER MARLBORO MD
20772-2881
US

V. Phone/Fax

Practice location:
  • Phone: 301-379-9654
  • Fax: 240-377-0226
Mailing address:
  • Phone: 410-903-5069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: