Provider Demographics
NPI:1265604946
Name:JONES, REBECCA DODRILL (MA MA CAS)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:DODRILL
Last Name:JONES
Suffix:
Gender:F
Credentials:MA MA CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:411 NORTH HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:WV
Mailing Address - Zip Code:26601-1147
Mailing Address - Country:US
Mailing Address - Phone:304-765-7101
Mailing Address - Fax:304-765-7148
Practice Address - Street 1:411 NORTH HILL ROAD
Practice Address - Street 2:BRAXTON COUNTRY BOARD OF EDUCATION
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601
Practice Address - Country:US
Practice Address - Phone:304-765-7101
Practice Address - Fax:304-765-7148
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10066103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool