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NPI Code Detail

MEDICARE: MANDY JONES M.ED

MEDICARE: MANDY JONES M.ED
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
1103K00000XBehavior Analyst168312KY

General Provider Information

NPI Number : 1164975454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY JONES M.ED
Provider Business Mailing Address
First Line : PO BOX 1659
Second Line :
City : SOMERSET
State : KY
Zip : 42502-1659
Country : US
Telephone Number : 606-677-2636
Fax Number : 606-677-0412
Provider Business Practice Location Address
First Line : 300 E MOUNT VERNON ST
Second Line :
City : SOMERSET
State : KY
Zip : 42501-1331
Country : US
Telephone Number : 606-677-2636
Fax Number : 606-677-0412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2016
Last Update Date : 08/03/2016

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