Healthcare Provider Details

I. General information

NPI: 1265987820
Provider Name (Legal Business Name): CIONDRIA JONES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BRIDGE ST SUITE 300
FT WORTH TX
76112-2384
US

IV. Provider business mailing address

PO BOX 227031
DALLAS TX
75222-7031
US

V. Phone/Fax

Practice location:
  • Phone: 972-674-9570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CIONDRIA JONES
Title or Position: CLINICAL PSYCHOLOGIST
Credential:
Phone: 214-405-7393