MEDICARE: JENNIFER JONES-REID

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

General Provider Information

NPI Number	:	1588109623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JONES-REID

Provider Business Mailing Address
First Line	:	14600 W 16TH ST S
Second Line	:	#27
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-9710
Country	:	US
Telephone Number	:	918-406-3483
Fax Number	:

Provider Business Practice Location Address
First Line	:	14600 W 16TH ST S
Second Line	:	#27
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-9710
Country	:	US
Telephone Number	:	918-406-3483
Fax Number	:

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

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	12/28/2016

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Directions to “ JENNIFER JONES-REID ” Practice Location

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