Provider Demographics
NPI:1356695407
Name:JONES, SHELLY A (BCBA)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 WEST ST STE F
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-4405
Mailing Address - Country:US
Mailing Address - Phone:860-613-9930
Mailing Address - Fax:
Practice Address - Street 1:666 HUCKLEBERRY HILL RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3233
Practice Address - Country:US
Practice Address - Phone:860-841-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst