MEDICARE: MS. AKENYA D JONES

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1205248895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AKENYA D JONES

Provider Business Mailing Address
First Line	:	777 N AIR DEPOT BLVD APT 3202
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-3765
Country	:	US
Telephone Number	:	682-551-6346
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 N AIR DEPOT BLVD APT 3202
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-3765
Country	:	US
Telephone Number	:	682-551-6346
Fax Number	:

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

Provider Enumeration Date	:	05/29/2014
Last Update Date	:	05/29/2014

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