Provider Demographics
NPI:1487065157
Name:JONES, CAROLYN MGCDF (GCDF12026)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MGCDF
Last Name:JONES
Suffix:
Gender:F
Credentials:GCDF12026
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 NTH. BEAVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008
Mailing Address - Country:US
Mailing Address - Phone:870-995-1270
Mailing Address - Fax:405-951-9232
Practice Address - Street 1:2209 NTH. BEAVER AVE.
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008
Practice Address - Country:US
Practice Address - Phone:870-995-1270
Practice Address - Fax:405-951-9232
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst