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General NPI Number Information
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NPI Number | 1215725775
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Entity Type | Individual
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Provider Name | TRELLIS N. JONES EDD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 402 PROSPECT ST
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City | LA PLATA
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State | MD
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Zip | 20646-9602
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Country | US
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Telephone | 301-974-2035
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Fax |
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Provider Business Mailing Address
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Address Line | 402 PROSPECT ST
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City | LA PLATA
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State | MD
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Zip | 20646-9602
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Country | US
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Telephone | 301-974-2035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | CER-59550-C3V5J0
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License Number State |
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