Provider Demographics
NPI:1962605923
Name:JONES, KATHERINE MARY (MA)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:MARY
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4231
Mailing Address - Country:US
Mailing Address - Phone:407-929-1914
Mailing Address - Fax:913-794-0831
Practice Address - Street 1:5720 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-4231
Practice Address - Country:US
Practice Address - Phone:407-929-1914
Practice Address - Fax:913-794-0831
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007015083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist