Basic Information
| Provider Information | |||||||||
| NPI: | 1114523214 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | TIAWANA | ||||||||
| MiddleName: | YOLANDA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1995 GENTILLY BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701191700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049440453 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1995 GENTILLY BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701191700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049440453 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2020 | ||||||||
| LastUpdateDate: | 12/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | LA | N | Agencies | Community/Behavioral Health | 171M00000X | LA | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.