Provider Demographics
NPI:1790558419
Name:JONES, JUDITH LAYTON
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LAYTON
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 1:1680 BRIARWOOD DR APT J2
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2840
Mailing Address - Country:US
Mailing Address - Phone:724-470-3202
Mailing Address - Fax:
Practice Address - Street 1:4731 ROUTE 30 STE 302
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7260
Practice Address - Country:US
Practice Address - Phone:724-850-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABS001160103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst