Provider Demographics
NPI:1790534303
Name:JONES, BRIANNA ROSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ROSE
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 1:35 ARAPAHO PL
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3428
Mailing Address - Country:US
Mailing Address - Phone:609-513-5121
Mailing Address - Fax:
Practice Address - Street 1:314 CHRIS GAUPP DR STE 202
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4464
Practice Address - Country:US
Practice Address - Phone:609-289-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01027300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist