Provider Demographics
NPI:1174624316
Name:JONES, ANNITA B (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNITA
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 LEHIGH PKWY E
Mailing Address - Street 2:STE 1C
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3000
Mailing Address - Country:US
Mailing Address - Phone:610-435-4142
Mailing Address - Fax:610-776-7101
Practice Address - Street 1:1600 LEHIGH PKWY E
Practice Address - Street 2:STE 1C
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3000
Practice Address - Country:US
Practice Address - Phone:610-435-4142
Practice Address - Fax:610-776-7101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006789-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA473598Medicare ID - Type UnspecifiedID NUMBER