MEDICARE: WILLETTE 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	106S00000X	Behavior Technician	RBT-24-324073	GA

General Provider Information

NPI Number	:	1225983430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLETTE JONES

Provider Business Mailing Address
First Line	:	6505 SHILOH RD STE 100
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-1645
Country	:	US
Telephone Number	:	678-648-7644
Fax Number	:

Provider Business Practice Location Address
First Line	:	12395 MORRIS RD STE 100
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4001
Country	:	US
Telephone Number	:	678-648-7644
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ WILLETTE JONES ” Practice Location

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