Provider Demographics
NPI:1780059154
Name:JONES, HEATHER MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BROOK PL
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1202
Mailing Address - Country:US
Mailing Address - Phone:917-653-4052
Mailing Address - Fax:914-930-7239
Practice Address - Street 1:4 BROOK PL
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-1202
Practice Address - Country:US
Practice Address - Phone:917-653-4052
Practice Address - Fax:914-930-7239
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2021-04-07
Deactivation Date:2016-09-23
Deactivation Code:
Reactivation Date:2021-04-07
Provider Licenses
StateLicense IDTaxonomies
NY014627-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist