Provider Demographics
NPI:1275246969
Name:JONES, ASHBY BLAYNE (BCBA)
Entity Type:Individual
Prefix:
First Name:ASHBY
Middle Name:BLAYNE
Last Name:JONES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-7229
Mailing Address - Country:US
Mailing Address - Phone:757-567-5989
Mailing Address - Fax:
Practice Address - Street 1:3212 LORTON CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7014
Practice Address - Country:US
Practice Address - Phone:757-383-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst