Provider Demographics
NPI:1972058592
Name:JONES, SANDRA SCHAEFER (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SCHAEFER
Last Name:JONES
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1291
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-1291
Mailing Address - Country:US
Mailing Address - Phone:318-306-0957
Mailing Address - Fax:
Practice Address - Street 1:721 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3137
Practice Address - Country:US
Practice Address - Phone:318-335-2953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1984235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist