MEDICARE: TWILA R JONES-HENDRIX

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	101Y00000X	Counselor	ALC04415	AL

General Provider Information

NPI Number	:	1811759194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TWILA R JONES-HENDRIX

Provider Business Mailing Address
First Line	:	1907 NORDAN LN
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-3525
Country	:	US
Telephone Number	:	334-318-4943
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 HARRISON RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109-4508
Country	:	US
Telephone Number	:	334-322-4437
Fax Number	:

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

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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