Provider Demographics
NPI:1992560478
Name:JONES, KIEONA ALEEMAHWALKER
Entity type:Individual
Prefix:
First Name:KIEONA
Middle Name:ALEEMAHWALKER
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 CHIMNEYTOP DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-6333
Mailing Address - Country:US
Mailing Address - Phone:804-426-8931
Mailing Address - Fax:
Practice Address - Street 1:3362 ASPEN GROVE DRIVE
Practice Address - Street 2:BUILDING F SUITE 604
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:629-236-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician