1710204557 NPI number — CRISTINA JONES SLP

Table of content: CRISTINA JONES SLP (NPI 1710204557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710204557 NPI number — CRISTINA JONES SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
CRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOWLER
Provider Other First Name:
CRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710204557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
53 PERIMETER CENTER EAST
Provider Second Line Business Mailing Address:
SUITE 550
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-822-9115
Provider Business Mailing Address Fax Number:
770-822-9457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4799 SUGARLOAF PKWY
Provider Second Line Business Practice Location Address:
SUITE K
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-822-9115
Provider Business Practice Location Address Fax Number:
770-822-9457
Provider Enumeration Date:
05/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP007222 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 227802335 . This is a "DRIVER'S LICENSE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com