Provider Demographics
NPI:1811041395
Name:JETT, ADRIENNE DEAN (PSYD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DEAN
Last Name:JETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:DEAN
Other - Last Name:SKRZYPEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2238 S HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4382
Mailing Address - Country:US
Mailing Address - Phone:614-751-0042
Mailing Address - Fax:614-751-0047
Practice Address - Street 1:2238 S HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4382
Practice Address - Country:US
Practice Address - Phone:614-751-0042
Practice Address - Fax:614-751-0047
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health