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General NPI Number Information
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NPI Number | 1558825695
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Entity Type | Individual
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Provider Name | JAMAAL M JONES
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Gender | Male
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 1005 S GLENDALE ST
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City | WICHITA
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State | KS
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Zip | 67218-3203
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Country | US
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Telephone | 316-768-9818
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Fax | 316-771-7319
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Provider Business Mailing Address
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Address Line | 1608 E TULSA ST
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City | WICHITA
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State | KS
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Zip | 67216-1464
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9650
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License Number State | KS
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