Provider Demographics
NPI:1386089852
Name:JONES, JUDITH SKIPPER (M S CCC/SLP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:SKIPPER
Last Name:JONES
Suffix:
Gender:F
Credentials:M S CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PEARMAN DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-3100
Mailing Address - Country:US
Mailing Address - Phone:864-260-5000
Mailing Address - Fax:
Practice Address - Street 1:400 PEARMAN DAIRY RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-3100
Practice Address - Country:US
Practice Address - Phone:864-260-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist