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General NPI Number Information
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NPI Number | 1194180125
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Entity Type | Organization
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Legal Business Name | LESLIE N. JONES, PH.D., L.L.C.
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 112 WESTWOODS DR
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City | LIBERTY
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State | MO
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Zip | 64068-1181
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Country | US
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Telephone | 816-785-9657
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WESTWOODS DR
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City | LIBERTY
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State | MO
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Zip | 64068-1181
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Country | US
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Telephone | 816-785-9657
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. LESLIE NICOLE JONES
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Credential | PH.D.
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Telephone | 816-785-9657
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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 | 2208
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2006038986
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License Number State | MO
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