Basic Information
Provider Information
NPI: 1992734248
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: JULIA
MiddleName: G
NamePrefix: MRS.
NameSuffix:  
Credential: M.A., CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3719 THORNTON HWY
Address2:  
City: CHARLOTTE
State: MI
PostalCode: 488139507
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5500 ARMSTRONG RD
Address2:  
City: BATTLE CREEK
State: MI
PostalCode: 490151014
CountryCode: US
TelephoneNumber: 2699665600
FaxNumber: 2699665567
Other Information
ProviderEnumerationDate: 06/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X  Y Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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