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NPI Code Detail

MEDICARE: MRS. TANYA LYNN JONES BA

MEDICARE: MRS. TANYA LYNN JONES BA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1508188616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TANYA LYNN JONES BA
Provider Business Mailing Address
First Line : 301 SAUNIER WAY
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7068
Country : US
Telephone Number : 918-470-6659
Fax Number :
Provider Business Practice Location Address
First Line : 727 E WYANDOTTE AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-5427
Country : US
Telephone Number : 580-581-7246
Fax Number : 580-581-7256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2010
Last Update Date : 07/23/2019

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