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General NPI Number Information
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NPI Number | 1497907067
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Entity Type | Organization
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Legal Business Name | ALISSA S. JONES, PH.D., P.A.
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 41900 FENWICK ST SUITE ONE
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City | LEONARDTOWN
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State | MD
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Zip | 20650-3813
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Country | US
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Telephone | 301-475-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 41900 FENWICK ST SUITE ONE
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City | LEONARDTOWN
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State | MD
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Zip | 20650-3813
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Country | US
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Telephone | 301-475-9660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALISSA SUE JONES
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Credential | PH.D.
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Telephone | 301-475-9660
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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 | 02901
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License Number State | MD
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