Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1577 | KY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 99035264A | IN |
NPI | 1053547679 |
---|---|
Provider Name | Brandi M Jones |
First Address | Cleveland, OH 44109-1900 |
Second Address | Cleveland, OH 44109-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 27/12/2021 |