Provider Demographics
NPI:1831290246
Name:IRONS, MARY JANE (PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:IRONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:501 FAULCONER DRIVE
Mailing Address - Street 2:SUTIE 2D
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-963-0324
Mailing Address - Fax:434-971-5625
Practice Address - Street 1:198 SPOTNAP ROAD
Practice Address - Street 2:SUITE A3
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902
Practice Address - Country:US
Practice Address - Phone:434-963-0324
Practice Address - Fax:434-971-5625
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical