Basic Information
| Provider Information | |||||||||
| NPI: | 1851763148 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | JOVANNA | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3253 CONGRESS AVE | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486023106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897934790 | ||||||||
| FaxNumber: | 9897931641 | ||||||||
| Practice Location | |||||||||
| Address1: | 3253 CONGRESS AVE | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897934790 | ||||||||
| FaxNumber: | 9897931641 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2015 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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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 | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 1041C0700X | 6801102843 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.