Provider Demographics
NPI:1528044435
Name:JONES, DAVID EUGENE (PHD, ABPP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EUGENE
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 482
Mailing Address - Street 2:BOX 2935
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362
Mailing Address - Country:US
Mailing Address - Phone:01181611-745-3009
Mailing Address - Fax:01181611-745-3939
Practice Address - Street 1:PSC 482
Practice Address - Street 2:BOX 2935
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96362
Practice Address - Country:JP
Practice Address - Phone:01181611-745-3009
Practice Address - Fax:01181611-745-3939
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002148103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical