Provider Demographics
NPI:1609017862
Name:JONES, CHERYL A (COTA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 MAYFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-7822
Mailing Address - Country:US
Mailing Address - Phone:216-659-6108
Mailing Address - Fax:
Practice Address - Street 1:470 MAYFLOWER AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-7822
Practice Address - Country:US
Practice Address - Phone:216-659-6108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002576224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant