Provider Demographics
NPI:1770237125
Name:JONES, OCTAVIA JOY
Entity Type:Individual
Prefix:
First Name:OCTAVIA
Middle Name:JOY
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 1:2523 PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2506
Mailing Address - Country:US
Mailing Address - Phone:863-657-8349
Mailing Address - Fax:
Practice Address - Street 1:2523 PARK PLZ
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2506
Practice Address - Country:US
Practice Address - Phone:863-657-8349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services