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NPI Code Detail

MEDICARE: MISS AMANDA JEAN JONES M.A.

MEDICARE: MISS AMANDA JEAN JONES M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor3969CO

General Provider Information

NPI Number : 1104961937
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS AMANDA JEAN JONES M.A.
Provider Business Mailing Address
First Line : 3383 SPRINGMEADOW CIR
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80109-7901
Country : US
Telephone Number : 303-521-1509
Fax Number :
Provider Business Practice Location Address
First Line : 4371 E 72ND AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1471
Country : US
Telephone Number : 303-853-3644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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