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General NPI Number Information
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NPI Number | 1497063432
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Entity Type | Individual
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Provider Name | ANGELA MICHELLE JONES PHD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 1003 SE 14TH ST STE 4
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City | BENTONVILLE
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State | AR
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Zip | 72712-6897
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Country | US
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Telephone | 479-408-3200
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Fax | 479-358-1430
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Provider Business Mailing Address
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Address Line | 1003 SE 14TH ST STE 4
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City | BENTONVILLE
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State | AR
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Zip | 72712-6897
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Country | US
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Telephone | 479-408-3200
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Fax | 479-358-1430
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 15-19P
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License Number State | AR
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