Provider Demographics
NPI:1326336181
Name:OGG, JESSE LAURA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JESSE
Middle Name:LAURA
Last Name:OGG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 CHESTNUT COMMONS
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-1441
Mailing Address - Country:US
Mailing Address - Phone:401-862-9783
Mailing Address - Fax:
Practice Address - Street 1:545 CHESTNUT COMMONS
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-1441
Practice Address - Country:US
Practice Address - Phone:401-862-9783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007500171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor