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General NPI Number Information
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NPI Number | 1821173451
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Entity Type | Individual
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Provider Name | HEATHER SUSAN JONES L.M.F.T
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 787 MAIN ST S UNIT A-5
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City | WOODBURY
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State | CT
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Zip | 06798-3741
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Country | US
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Telephone | 203-903-9712
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Fax |
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Provider Business Mailing Address
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Address Line | 787 MAIN STREET SOUTH SUITE A5
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City | WOODBURY
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State | CT
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Zip | 06798
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Country | US
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Telephone | 203-903-9712
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001074
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License Number State | CT
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