Provider Demographics
NPI:1336420918
Name:JONES, CHRISTINA CATHERINE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CATHERINE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:CATHERINE
Other - Last Name:WILKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3629 WESTERN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-1939
Mailing Address - Country:US
Mailing Address - Phone:817-232-9400
Mailing Address - Fax:817-232-9403
Practice Address - Street 1:3629 WESTERN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-1939
Practice Address - Country:US
Practice Address - Phone:817-232-9400
Practice Address - Fax:817-232-9403
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64459101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional