Provider Demographics
NPI:1285035360
Name:JONES, STEPHANIE (MS)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OAK ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28465-7405
Mailing Address - Country:US
Mailing Address - Phone:910-471-1105
Mailing Address - Fax:
Practice Address - Street 1:110 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:OAK ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28465-7405
Practice Address - Country:US
Practice Address - Phone:910-471-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily