Provider Demographics
NPI:1578657078
Name:OGLE, JENNIFER (MSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:OGLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4693
Mailing Address - Country:US
Mailing Address - Phone:217-238-4866
Mailing Address - Fax:217-238-4868
Practice Address - Street 1:1005 HEALTH CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4693
Practice Address - Country:US
Practice Address - Phone:217-238-4866
Practice Address - Fax:217-238-4868
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker