Provider Demographics
NPI:1275025306
Name:JONES, CHANIENE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHANIENE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 MALLORY LN
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6867
Mailing Address - Country:US
Mailing Address - Phone:704-989-8225
Mailing Address - Fax:
Practice Address - Street 1:253 CRAIG MANOR RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6531
Practice Address - Country:US
Practice Address - Phone:803-286-1464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist