Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C2524A | AL |
NPI | 1003280603 |
---|---|
Provider Name | Alisa S Jones |
First Address | Montgomery, AL 36106-2316 |
Second Address | Montgomery, AL 36106-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2015 |
Last Update Date | 19/11/2015 |