Provider Demographics
NPI:1972624153
Name:JONES, STEPHANIE B (EDD)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:EDD
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 33
Mailing Address - Street 2:
Mailing Address - City:SERGEANTSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08557
Mailing Address - Country:US
Mailing Address - Phone:609-397-0612
Mailing Address - Fax:609-397-4076
Practice Address - Street 1:679 ON ROUTE 604
Practice Address - Street 2:
Practice Address - City:SERGEANTSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08557
Practice Address - Country:US
Practice Address - Phone:609-397-0612
Practice Address - Fax:609-397-4076
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAP5006991L103TC0700X
MA4686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical