Provider Demographics
NPI:1316953573
Name:JONES, KENDRA TAYLOR
Entity type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:TAYLOR
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 1:8457 FRIEDEN TRL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3347
Mailing Address - Country:US
Mailing Address - Phone:901-301-0332
Mailing Address - Fax:901-753-9487
Practice Address - Street 1:8457 FRIEDEN TRL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3347
Practice Address - Country:US
Practice Address - Phone:901-301-0332
Practice Address - Fax:901-753-9487
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2983225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2983OtherTN OCCUPATIONAL THERAPY