Jones, Jodi Polaha
Jones, Jodi Polaha is an sole proprietor health care provider with primary practice located at 917 W Walnut St , Johnson City TN 37604-6527. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jones, Jodi Polaha can be contacted via phone (423) 439-6464.Contact Information
Primary practice address
917 W Walnut St
Johnson City TN 37604-6527
Phone: (423) 439-6464
Fax: (423) 439-7118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2737 | Tennessee |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | P2737 | Tennessee |
Profile Details
| NPI number | 1841472586 |
|---|---|
| LBN Legal business name | Jones, Jodi Polaha |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2007 |
| Last updated | Jan 18th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841472586 | NPPES |
| Tennessee | MEDICAID | 1514093 |
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