Provider Demographics
NPI:1962560086
Name:JONES, AMBER BRIANA (PSYD)
Entity type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:BRIANA
Last Name:JONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 MCKELVEY RD
Mailing Address - Street 2:STE. 116
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2531
Mailing Address - Country:US
Mailing Address - Phone:314-209-0900
Mailing Address - Fax:314-209-0912
Practice Address - Street 1:3394 MCKELVEY RD
Practice Address - Street 2:STE. 116
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2531
Practice Address - Country:US
Practice Address - Phone:314-209-0900
Practice Address - Fax:314-209-0912
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006036650103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical