Provider Demographics
NPI:1730470683
Name:KOSIER, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KOSIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 N PORTLAND AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6170
Mailing Address - Country:US
Mailing Address - Phone:405-605-3093
Mailing Address - Fax:405-601-5682
Practice Address - Street 1:4911 N PORTLAND AVE STE 111
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6170
Practice Address - Country:US
Practice Address - Phone:405-605-3093
Practice Address - Fax:405-601-5682
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health