Provider Demographics
NPI:1144388026
Name:JONES, TONYA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6975 WOOD RIVER GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-1258
Mailing Address - Country:US
Mailing Address - Phone:719-591-8188
Mailing Address - Fax:719-573-8041
Practice Address - Street 1:6975 WOOD RIVER GRV
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-1258
Practice Address - Country:US
Practice Address - Phone:719-591-8188
Practice Address - Fax:719-573-8041
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0337824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79884580Medicaid