Provider Demographics
NPI:1588702104
Name:JONES, EMMA P (BA DCH)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:P
Last Name:JONES
Suffix:
Gender:F
Credentials:BA DCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354
Mailing Address - Country:US
Mailing Address - Phone:509-943-9104
Mailing Address - Fax:509-943-7206
Practice Address - Street 1:1175 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354
Practice Address - Country:US
Practice Address - Phone:509-943-9104
Practice Address - Fax:509-943-7206
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00012256101Y00000X
CP00000624101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)