Provider Demographics
NPI:1104335264
Name:JONES, ANYA NEWMAN (LAC)
Entity type:Individual
Prefix:
First Name:ANYA
Middle Name:NEWMAN
Last Name:JONES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 HIGH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-3914
Mailing Address - Country:US
Mailing Address - Phone:410-778-1099
Mailing Address - Fax:410-778-7988
Practice Address - Street 1:860 HIGH ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-3909
Practice Address - Country:US
Practice Address - Phone:410-778-2860
Practice Address - Fax:410-778-7988
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02423171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist