Provider Demographics
NPI:1891534251
Name:JONES, REBECCA MICHELLE (RBT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11825 CHASE WELLESLEY DR APT 701
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7761
Mailing Address - Country:US
Mailing Address - Phone:804-300-3784
Mailing Address - Fax:
Practice Address - Street 1:1550 OAKBRIDGE DR
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-8063
Practice Address - Country:US
Practice Address - Phone:804-557-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-23-258883106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician