Provider Demographics
NPI:1124467840
Name:JONES, RACHELLE
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S BROADWAY STE 5
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3848
Mailing Address - Country:US
Mailing Address - Phone:405-204-8482
Mailing Address - Fax:
Practice Address - Street 1:3000 UNITED FOUNDERS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4294
Practice Address - Country:US
Practice Address - Phone:405-204-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-15
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health