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
Fax: (423) 439-7118
Website:

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841472586 NPPES
Tennessee MEDICAID 1514093

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