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Provider Information for 1679993943


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KILIKO TANAKA JONES


Sex: Female

NPI: 1679993943
Last Updated: 2014-04-24
Certification Date:

Details

NameValue
NPI1679993943
Enumeration Date2014-04-24
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 223 MAIN ST
BEACON, NY 12508-2770
United States

Phone: 845-838-4900 | Fax:845-838-4915
 
Primary Practice Address 223 MAIN ST
BEACON, NY 12508-2770
United States

Phone: 845-838-4900 | Fax:845-838-4915
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalNYP88996