Provider Demographics
NPI:1598019895
Name:JONES, CHANAE NATHASIA HERMIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHANAE
Middle Name:NATHASIA HERMIE
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 1:18107 CLOVER PARK DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4435
Mailing Address - Country:US
Mailing Address - Phone:832-639-4066
Mailing Address - Fax:
Practice Address - Street 1:9701 N SAM HOUSTON PKWY E
Practice Address - Street 2:STE 120
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4693
Practice Address - Country:US
Practice Address - Phone:337-257-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114853225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist