Provider Demographics
NPI:1447947882
Name:JONES, KEANDRA K
Entity type:Individual
Prefix:
First Name:KEANDRA
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 APRIL BLOOM # B
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-1807
Mailing Address - Country:US
Mailing Address - Phone:254-627-0297
Mailing Address - Fax:
Practice Address - Street 1:217 E SCENIC PEAK CV
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9222
Practice Address - Country:US
Practice Address - Phone:801-282-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109806104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker