MEDICARE: MS. KRISTI LOUISE JONES LPC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		IL

General Provider Information

NPI Number	:	1477564904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTI LOUISE JONES LPC

Provider Business Mailing Address
First Line	:	CMR 461, BOX 3081
Second Line	:
City	:	APO
State	:	AE
Zip	:	09703
Country	:	NL
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CMR 461, BOX 3081
Second Line	:
City	:	APO
State	:	AE
Zip	:	09703
Country	:	NL
Telephone Number	:	31455636091
Fax Number	:	6094

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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