Provider Demographics
NPI:1609175405
Name:JONES, SANDRA LEE
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:WY
Mailing Address - Zip Code:82939-0102
Mailing Address - Country:US
Mailing Address - Phone:435-778-0025
Mailing Address - Fax:
Practice Address - Street 1:210 RIVERBEND DRIVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:WY
Practice Address - Zip Code:82939
Practice Address - Country:US
Practice Address - Phone:307-747-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator