Provider Demographics
NPI:1699160069
Name:JONES, TERESA (HAS, BC-HIS, RN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:HAS, BC-HIS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 SANTA BARBARA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-4333
Mailing Address - Country:US
Mailing Address - Phone:239-673-9507
Mailing Address - Fax:239-673-9509
Practice Address - Street 1:2209 SANTA BARBARA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-4333
Practice Address - Country:US
Practice Address - Phone:239-673-9507
Practice Address - Fax:239-673-9509
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4202237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist