Basic Information
Provider Information
NPI: 1346874294
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: SHONEIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9450 GROGANS MILL RD STE 150
Address2:  
City: SPRING
State: TX
PostalCode: 773803666
CountryCode: US
TelephoneNumber: 8326163075
FaxNumber:  
Practice Location
Address1: 2620 FORUM BLVD STE E
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652035454
CountryCode: US
TelephoneNumber: 5733030553
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/01/2020
LastUpdateDate: 03/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X122020TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
106S00000X  N    

No ID Information.


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