Provider Demographics
NPI:1063748895
Name:JONES, AMY KRISTINE (MS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KRISTINE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 BELMONT PT.
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:68122
Mailing Address - Country:US
Mailing Address - Phone:217-366-0033
Mailing Address - Fax:217-366-0012
Practice Address - Street 1:703 COUNTRY VIEW DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:68122
Practice Address - Country:US
Practice Address - Phone:217-366-0033
Practice Address - Fax:217-366-0012
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010422235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist