Provider Demographics
NPI:1851915565
Name:JONES, SANDRA BETTY
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:BETTY
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 1:857 RUGBY ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2049
Mailing Address - Country:US
Mailing Address - Phone:757-510-1193
Mailing Address - Fax:
Practice Address - Street 1:4020 RAINTREE RD STE C
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3749
Practice Address - Country:US
Practice Address - Phone:757-292-4162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician