Provider Demographics
NPI:1184099368
Name:JONES, CATHERINE JANE VICTORIA
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JANE VICTORIA
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 1:1014B PLANTERS LN
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-2493
Mailing Address - Country:US
Mailing Address - Phone:478-268-2053
Mailing Address - Fax:
Practice Address - Street 1:1014B PLANTERS LN
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-2493
Practice Address - Country:US
Practice Address - Phone:478-268-2053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051848397103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist