Doctor Name: | SANDRA JONES |
NPI Number: | 1598004475 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPES |
License Number: | 4597 |
Business Practice Address: | 205 King St Latta, SC - 295651401 |
Business Phone Number: | 8437527101 |
Business Fax Number: | |
Mailing Address: | 1086 Judge Rd, DILLON |
State: | SC |
Postal Code: | 295368229 |
Phone Number: | 8437741854 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2013 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 4597 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |