Provider Demographics
NPI:1992547525
Name:JONES, MILFRED EMILE
Entity type:Individual
Prefix:
First Name:MILFRED
Middle Name:EMILE
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7630 LITTLE RIVER TPKE STE 3
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2643
Mailing Address - Country:US
Mailing Address - Phone:240-716-1044
Mailing Address - Fax:
Practice Address - Street 1:7630 LITTLE RIVER TPKE STE 3
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2643
Practice Address - Country:US
Practice Address - Phone:240-716-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
10102103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities