Provider Demographics
NPI:1437656451
Name:JONES, MERRITT (COTA/L)
Entity type:Individual
Prefix:MS
First Name:MERRITT
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7342A S BARKER CIR
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-3201
Mailing Address - Country:US
Mailing Address - Phone:256-239-6223
Mailing Address - Fax:
Practice Address - Street 1:298 WARFIELD BLVD STE C
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-1828
Practice Address - Country:US
Practice Address - Phone:931-906-0440
Practice Address - Fax:931-920-5070
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3055224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant