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General NPI Number Information
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NPI Number | 1427353366
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Entity Type | Individual
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Provider Name | BEVERLY D JONAS MHS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 1 RAIDER LN SPECIAL EDUCATION DEPT.
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City | HORSEHEADS
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State | NY
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Zip | 14845-2344
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Country | US
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Telephone | 607-739-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 8455 COUNTY ROUTE 125 GST BOCES ITINERANT AND RELATED SERVICES
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City | CAMPBELL
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State | NY
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Zip | 14821-9518
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Country | US
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Telephone | 607-776-6788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 005142-1
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License Number State | NY
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