Provider Demographics
NPI:1114295359
Name:JONES, HEATHER A (PHD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23284-9038
Mailing Address - Country:US
Mailing Address - Phone:804-828-5641
Mailing Address - Fax:804-828-2237
Practice Address - Street 1:806 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23284-9038
Practice Address - Country:US
Practice Address - Phone:804-828-5641
Practice Address - Fax:804-828-2237
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical