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General NPI Number Information
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NPI Number | 1679379770
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Entity Type | Individual
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Provider Name | JESSICA JONES
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Gender | Female
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 200 HARRIS ST
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City | WHITEVILLE
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State | TN
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Zip | 38075-4862
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Country | US
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Telephone | 731-609-8018
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 362
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City | WHITEVILLE
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State | TN
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Zip | 38075-0362
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Country | US
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Telephone | 731-609-8018
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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 | RBT-22-252057
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License Number State | TN
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