Provider Demographics
NPI:1336958222
Name:JONES, KYLEE REGINA MARI (TLMHC)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:REGINA MARI
Last Name:JONES
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 W WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2449
Mailing Address - Country:US
Mailing Address - Phone:402-515-5639
Mailing Address - Fax:
Practice Address - Street 1:1527 ALBIA RD
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3907
Practice Address - Country:US
Practice Address - Phone:641-682-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA130113101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health