MEDICARE: MRS. ALISA MARIE JONES CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	2007000365	MO

General Provider Information

NPI Number	:	1184810723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISA MARIE JONES CCC-SLP

Provider Business Mailing Address
First Line	:	12546 W 110TH TER
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-1274
Country	:	US
Telephone Number	:	913-710-7622
Fax Number	:

Provider Business Practice Location Address
First Line	:	12546 W 110TH TER
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-1274
Country	:	US
Telephone Number	:	913-710-7622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	08/11/2014

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