Doctor Name: | BENNIE DAVID JONES |
NPI Number: | 1134511777 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C-A |
License Number: | A10774 |
Business Practice Address: | 710 S Layton Ave Dunn Dunn, NC - 283345742 |
Business Phone Number: | 9807215711 |
Business Fax Number: | |
Mailing Address: | 710 S Layton Ave, Dunn DUNN |
State: | NC |
Postal Code: | 283345742 |
Phone Number: | 9807215711 |
Fax Number: | |
NPI Enumeration Date: | 02/19/2015 |
NPI Last Update Date: | 02/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | A10774 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |