Provider Demographics
NPI:1528774882
Name:JONES, THERESA ELAINE (MA, MSED, MED)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ELAINE
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, MSED, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MOULTON RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:NH
Mailing Address - Zip Code:03836-5023
Mailing Address - Country:US
Mailing Address - Phone:201-259-1806
Mailing Address - Fax:
Practice Address - Street 1:161 MOULTON RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:NH
Practice Address - Zip Code:03836-5023
Practice Address - Country:US
Practice Address - Phone:201-259-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency