Basic Information
Provider Information
NPI: 1568955565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINZEL
FirstName: JESSICA
MiddleName: I
NamePrefix:  
NameSuffix:  
Credential: B.A., QMHS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 796 STONEY RD
Address2:  
City: PEEBLES
State: OH
PostalCode: 456608928
CountryCode: US
TelephoneNumber: 9377989052
FaxNumber:  
Practice Location
Address1: 108 ERIN CT
Address2:  
City: HILLSBORO
State: OH
PostalCode: 451338591
CountryCode: US
TelephoneNumber: 9373939946
FaxNumber: 9373932518
Other Information
ProviderEnumerationDate: 06/13/2018
LastUpdateDate: 06/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XC.1800815-TRNEOHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home