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General NPI Number Information
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NPI Number | 1598004475
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Entity Type | Individual
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Provider Name | SANDRA JONES LPES
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Gender | Female
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 205 KING ST
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City | LATTA
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State | SC
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Zip | 29565-1401
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Country | US
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Telephone | 843-752-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 1086 JUDGE RD
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City | DILLON
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State | SC
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Zip | 29536-8229
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Country | US
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Telephone | 843-774-1854
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 4597
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License Number State | SC
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