Provider Demographics
NPI:1457029183
Name:JONES, SOPHIA MARIE (DSP)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2919
Mailing Address - Country:US
Mailing Address - Phone:989-494-0553
Mailing Address - Fax:
Practice Address - Street 1:835 MIDDLETON RD
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-8837
Practice Address - Country:US
Practice Address - Phone:989-494-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant