Provider Demographics
NPI:1245430149
Name:JONES, SANDRA SHIPLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:SHIPLEY
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 1:1879 AMANDA LANE
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048
Mailing Address - Country:US
Mailing Address - Phone:410-795-2166
Mailing Address - Fax:410-795-8391
Practice Address - Street 1:1812 BALTIMORE BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7146
Practice Address - Country:US
Practice Address - Phone:410-386-0620
Practice Address - Fax:410-795-8391
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCO469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional