Provider Demographics
NPI:1174089684
Name:JONES, KATHRYN BIGALKE (PHD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BIGALKE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LYNCH
Other - Last Name:BIGALKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 DAME KATHRYN DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-1604
Mailing Address - Country:US
Mailing Address - Phone:864-616-6353
Mailing Address - Fax:
Practice Address - Street 1:7130 HODGSON MEMORIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1527
Practice Address - Country:US
Practice Address - Phone:912-355-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004059103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA14410689OtherCAQH