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General NPI Number Information
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NPI Number | 1306501663
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Entity Type | Individual
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Provider Name | MS. ALYSSA SUZANNE JONES
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Gender | Female
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 2746 GULF BREEZE PKWY UNIT B
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City | GULF BREEZE
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State | FL
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Zip | 32563-4952
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Country | US
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Telephone | 850-780-9726
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 QUARTZ AVE
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City | CANTONMENT
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State | FL
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Zip | 32533-6335
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Country | US
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Telephone | 850-780-9726
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH20156
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License Number State | FL
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