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NPI 1881793412

NPI 1881793412 : SHAWANA RENAE JONES LMSW : JACKSON, MS

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General NPI Number Information
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    NPI Number           |    1881793412
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    Entity Type          |    Individual 
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    Provider Name        |    SHAWANA RENAE JONES LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/21/2006
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    Last Update Date     |    01/28/2009
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Provider Practice Location Address
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    Address Line         |    1500 E WOODROW WILSON AVE 
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    City                 |    JACKSON
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    State                |    MS
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    Zip                  |    39216-5116
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    Country              |    US
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    Telephone            |    601-364-1523
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    48 LESTER CV 
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    City                 |    BYRAM
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    State                |    MS
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    Zip                  |    39272-9424
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    Country              |    US
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    Telephone            |    601-364-1523
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    M5679
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    License Number State |    MS
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