Provider Demographics
NPI:1124473806
Name:JONES, ALICIA (MS, SLP)
Entity type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1740 HUDSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6331
Mailing Address - Country:US
Mailing Address - Phone:404-474-1627
Mailing Address - Fax:404-474-8937
Practice Address - Street 1:1740 HUDSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6331
Practice Address - Country:US
Practice Address - Phone:404-474-1627
Practice Address - Fax:404-474-8937
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET0023192355S0801X
GASLP009505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant