Provider Demographics
NPI:1851618698
Name:JONES-MCCALOP, DEMIRRA
Entity Type:Individual
Prefix:MRS
First Name:DEMIRRA
Middle Name:
Last Name:JONES-MCCALOP
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 1:106 WINTHROP ST
Mailing Address - Street 2:APT 3
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-2328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:106 WINTHROP ST
Practice Address - Street 2:APT 3
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-2328
Practice Address - Country:US
Practice Address - Phone:617-980-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker