Provider Demographics
NPI:1790721702
Name:OSSEGE, JENNIFER MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:OSSEGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 S FORT THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2453
Mailing Address - Country:US
Mailing Address - Phone:859-442-8439
Mailing Address - Fax:859-781-0123
Practice Address - Street 1:1455 S FORT THOMAS AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2453
Practice Address - Country:US
Practice Address - Phone:859-442-8439
Practice Address - Fax:859-781-0123
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1404103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical