Provider Demographics
NPI:1801038708
Name:JONES, SHALLIMAR M (PHD)
Entity type:Individual
Prefix:DR
First Name:SHALLIMAR
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18585 COASTAL HWY
Mailing Address - Street 2:UNIT 10 PMB 2021
Mailing Address - City:REHOBOTH
Mailing Address - State:DE
Mailing Address - Zip Code:19971
Mailing Address - Country:US
Mailing Address - Phone:302-414-0963
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED ARMY MEDICAL CTR
Practice Address - Street 2:6900 GEORGIA AVENUE, N.W.
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:301-706-6678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000806103TC0700X
MD04495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical