Doctor Name: | GAYLAN I JONES |
NPI Number: | 1588704043 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 682 W School Bus Ln Snowflake, AZ - 859375262 |
Business Phone Number: | 9285364156 |
Business Fax Number: | 9285364246 |
Mailing Address: | Po Box 2738, SNOWFLAKE |
State: | AZ |
Postal Code: | 859372738 |
Phone Number: | 9285364156 |
Fax Number: | 9285364246 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |