Healthcare Provider Details

I. General information

NPI: 1457966624
Provider Name (Legal Business Name): CHLOE MEGAN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W 13 MILE RD
ROYAL OAK MI
48073-6515
US

IV. Provider business mailing address

30301 NORTHWESTERN HWY STE 100
FARMINGTON HILLS MI
48334-3277
US

V. Phone/Fax

Practice location:
  • Phone: 248-549-4339
  • Fax:
Mailing address:
  • Phone: 248-837-2033
  • Fax: 248-554-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401002261
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: