Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813001094 | VA |
NPI | 1073107389 |
---|---|
Provider Name | Jacquelyn Sue Jones |
First Address | Prince George, VA 23875-0400 |
Second Address | Prince George, VA 23875-2562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |