Basic Information
| Provider Information | |||||||||
| NPI: | 1245899327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | JEWEL | ||||||||
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| Credential: | CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6001 OLD SHELL RD APT 102M | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6017172088 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1290 E NINE MILE RD | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325141653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508579343 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2019 | ||||||||
| LastUpdateDate: | 06/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SZ9066 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.