NPI | 1104271089 |
---|---|
Former Name | JENNA LYNN OSKING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2019-0899) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-28 |
Last Update Date | 2021-07-19 |