Provider Demographics
NPI:1487096673
Name:JONES, ALICIA (BA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 ALBEMARLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6617
Mailing Address - Country:US
Mailing Address - Phone:704-806-1933
Mailing Address - Fax:704-568-7025
Practice Address - Street 1:4915 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6617
Practice Address - Country:US
Practice Address - Phone:704-806-1933
Practice Address - Fax:704-568-7025
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator