Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 103TC1900X | Counseling Psychologist | ||
Y | 106S00000X | Behavior Technician |
NPI | 1033775309 |
---|---|
Provider Name | Jakyra Jones |
First Address | Delphos, OH 45833-9058 |
Second Address | Merrillville, IN 46410-6394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2019 |
Last Update Date | 13/05/2019 |