MEDICARE: THERESA ELAINE JONES MA, MSED, MED

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	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1528774882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA ELAINE JONES MA, MSED, MED

Provider Business Mailing Address
First Line	:	161 MOULTON RD
Second Line	:
City	:	FREEDOM
State	:	NH
Zip	:	03836-5023
Country	:	US
Telephone Number	:	201-259-1806
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 MOULTON RD
Second Line	:
City	:	FREEDOM
State	:	NH
Zip	:	03836-5023
Country	:	US
Telephone Number	:	201-259-1806
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	01/30/2023

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