Provider Demographics
NPI:1891702619
Name:JONES, MYLEE KENA (MS)
Entity type:Individual
Prefix:
First Name:MYLEE
Middle Name:KENA
Last Name:JONES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S CHICKASAW ST
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-5820
Mailing Address - Country:US
Mailing Address - Phone:405-926-7712
Mailing Address - Fax:405-207-9433
Practice Address - Street 1:1001 S CHICKASAW ST
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-5820
Practice Address - Country:US
Practice Address - Phone:405-926-7712
Practice Address - Fax:405-207-9433
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health