Provider Demographics
NPI:1275984734
Name:OCKANDER, JENA M (SLP)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:M
Last Name:OCKANDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:M
Other - Last Name:MENTINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:361 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:NE
Mailing Address - Zip Code:68651-4803
Mailing Address - Country:US
Mailing Address - Phone:402-366-3926
Mailing Address - Fax:
Practice Address - Street 1:361 RIDGE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:NE
Practice Address - Zip Code:68651-4803
Practice Address - Country:US
Practice Address - Phone:402-366-3926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1678235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist