Provider Demographics
NPI:1144913757
Name:JONES, LORENZO (CPRS)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 N MARKET ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5795
Mailing Address - Country:US
Mailing Address - Phone:240-315-4675
Mailing Address - Fax:
Practice Address - Street 1:1890 N MARKET ST STE 301
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3033
Practice Address - Country:US
Practice Address - Phone:301-696-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPR0678175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist