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General NPI Number Information
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NPI Number | 1114177920
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Entity Type | Organization
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Legal Business Name | LISA M. JONES, PH.D., LLC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 221 W 2ND ST SUITE 105
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City | NORTH PLATTE
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State | NE
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Zip | 69101-3966
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Country | US
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Telephone | 308-532-3000
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Fax | 308-532-4164
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Provider Business Mailing Address
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Address Line | 221 W 2ND ST SUITE 105
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City | NORTH PLATTE
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State | NE
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Zip | 69101-3966
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Country | US
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Telephone | 308-532-3000
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Fax | 308-532-4164
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | LISA M. JONES
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Credential | PH.D.
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Telephone | 308-532-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 486
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License Number State | NE
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