=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114033297
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALISON W JONES PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2006
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 415 W GRAND RIVER AVE
-----------------------------------------------------
City | EAST LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48823-4201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-332-0300
-----------------------------------------------------
Fax | 517-337-1041
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 415 W GRAND RIVER AVE
-----------------------------------------------------
City | EAST LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48823-4201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-332-0300
-----------------------------------------------------
Fax | 517-337-1041
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 6301002893
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------