Provider Demographics
NPI:1114560844
Name:JONES, CRYSTAL ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:ELIZABETH
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2012 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4424
Mailing Address - Country:US
Mailing Address - Phone:202-945-3074
Mailing Address - Fax:
Practice Address - Street 1:2012 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4424
Practice Address - Country:US
Practice Address - Phone:202-945-3074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician