Provider Demographics
NPI:1730314931
Name:JONES-MCNAMARA, SARA 'SALLY' J (MCS, CCC-SLP, CCE)
Entity Type:Individual
Prefix:MRS
First Name:SARA 'SALLY'
Middle Name:J
Last Name:JONES-MCNAMARA
Suffix:
Gender:F
Credentials:MCS, CCC-SLP, CCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4289 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3276
Mailing Address - Country:US
Mailing Address - Phone:703-795-6692
Mailing Address - Fax:937-912-9056
Practice Address - Street 1:4289 COVENTRY CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-3276
Practice Address - Country:US
Practice Address - Phone:703-795-6692
Practice Address - Fax:937-912-9056
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA912235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist