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General NPI Number Information
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NPI Number | 1821448507
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Entity Type | Individual
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Provider Name | TIMOTHY JONES
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Gender | Male
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 6859 BELFORT OAKS PL
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6242
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Country | US
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Telephone | 904-862-2667
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Fax |
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Provider Business Mailing Address
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Address Line | 16 CALUMET DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-8724
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Country | US
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Telephone | 845-674-7053
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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