Individual
EDLYN N JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
6820 PARKDALE PLACE, SUITE 115, INDIANAPOLIS, IN 46254-4699
(317) 329-7300
(317) 329-7325
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040806
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200123130
—
IN
Enumeration date
06/16/2006
Last updated
11/20/2020
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