Doctor Name: | MIKA JONES |
NPI Number: | 1417367160 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | |
Business Practice Address: | 69 Corey Hill Rd Ashburnham, MA - 014301263 |
Business Phone Number: | 5083603238 |
Business Fax Number: | |
Mailing Address: | 250 Commercial St, Suite 200 WORCESTER |
State: | MA |
Postal Code: | 016081726 |
Phone Number: | 5087524665 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2014 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |