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Individual

DR. JODI POLAHA JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(423) 439-6464
(423) 439-7118
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-6464
(423) 439-7118

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2737
TN
103TC0700X
Clinical Psychologist
Primary
P2737
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1514093
TN
Enumeration date
12/05/2007
Last updated
01/18/2024
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