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General NPI Number Information
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NPI Number | 1790035186
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Entity Type | Organization
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Legal Business Name | JONA LESAGE MALONEY
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 122 WINDSOR AVE 2ND FLOOR
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City | MERIDEN
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State | CT
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Zip | 06451
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Country | US
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Telephone | 860-518-5557
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Fax |
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Provider Business Mailing Address
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Address Line | 122 WINDSOR AVE 2ND FLOOR
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City | MERIDEN
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State | CT
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Zip | 06451
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Country | US
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Telephone | 860-518-5557
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SERVICES
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Name | MRS. JONA LEE JEFFCOAT
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Credential | MT-BC
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Telephone | 860-518-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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