Doctor Name: | SUSAN JENNER |
NPI Number: | 1154307072 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 2003020995 |
Business Practice Address: | 102 N 1st St Owensville, MO - 650661302 |
Business Phone Number: | 5734372959 |
Business Fax Number: | 5734372974 |
Mailing Address: | 2042 Krausetown Rd, OWENSVILLE |
State: | MO |
Postal Code: | 650662803 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2003020995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |