Provider Demographics
NPI:1154548246
Name:JONSSON, DEVONNA KAE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEVONNA
Middle Name:KAE
Last Name:JONSSON
Suffix:
Gender:F
Credentials:PSYD
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 655
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-0655
Mailing Address - Country:US
Mailing Address - Phone:717-877-9090
Mailing Address - Fax:717-240-2844
Practice Address - Street 1:1104 FERNWOOD AVE STE 201
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-6902
Practice Address - Country:US
Practice Address - Phone:717-877-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009221L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50053743OtherCAPITAL BLUECROSS - INDIV
PA000789050OtherHIGHMARK BLUE SHIELD
PA50053742OtherCAPITAL BLUECROSS - GROUP