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General NPI Number Information
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NPI Number | 1730602715
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Entity Type | Individual
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Provider Name | KATHERINE JONES
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 704 CENTRAL AVE
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City | SUMMERVILLE
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State | SC
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Zip | 29483-3752
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Country | US
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Telephone | 843-209-4694
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Fax |
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Provider Business Mailing Address
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Address Line | 624 W RICHARDSON AVE
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6032
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Country | US
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Telephone | 843-209-4694
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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 | 5054
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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