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General NPI Number Information
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NPI Number | 1972944346
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Entity Type | Individual
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Provider Name | AMANDA JONES
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Gender | Female
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 540 MINOR ST
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City | ALPENA
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State | MI
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Zip | 49707-1625
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Country | US
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Telephone | 989-464-7079
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Fax |
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Provider Business Mailing Address
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Address Line | 16200 19 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1103
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Country | US
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Telephone | 586-464-2613
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L2498772
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License Number State | MI
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