Provider Demographics
NPI:1538364146
Name:JONES, SHELIA MALINDA (RD LD)
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:MALINDA
Last Name:JONES
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:MISS
Other - First Name:SHELIA
Other - Middle Name:MALINDA
Other - Last Name:WILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1458 BARNACLE ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-1802
Mailing Address - Country:US
Mailing Address - Phone:770-516-8639
Mailing Address - Fax:
Practice Address - Street 1:1458 BARNACLE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-1802
Practice Address - Country:US
Practice Address - Phone:770-516-8639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003103133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered