Provider Demographics
NPI:1356850275
Name:JONES, REBECCA RUTH (OCPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:RUTH
Last Name:JONES
Suffix:
Gender:F
Credentials:OCPC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:RUTH
Other - Last Name:HOYLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OCPS
Mailing Address - Street 1:2621 VICTORY PKWY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1754
Mailing Address - Country:US
Mailing Address - Phone:513-684-7966
Mailing Address - Fax:513-684-7983
Practice Address - Street 1:1908 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-4007
Practice Address - Country:US
Practice Address - Phone:513-363-1874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOCPC161310405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional