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General NPI Number Information
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NPI Number | 1679204853
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Entity Type | Individual
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Provider Name | MONTRIL JONES
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Gender | Male
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 1400 BROWNING RD STE 195
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City | COLUMBIA
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State | SC
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Zip | 29210-6941
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Country | US
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Telephone | 803-999-3752
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Fax | 615-815-1946
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Provider Business Mailing Address
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Address Line | 333 W BUTLER ST
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City | LEXINGTON
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State | SC
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Zip | 29072-2605
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Country | US
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Telephone | 803-714-3446
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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