Provider Demographics
NPI:1932514452
Name:MEINIG, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:MEINIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:ODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1251 NE ELM ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1206
Mailing Address - Country:US
Mailing Address - Phone:541-323-5374
Mailing Address - Fax:541-416-2066
Practice Address - Street 1:1251 NE ELM ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1206
Practice Address - Country:US
Practice Address - Phone:541-323-5374
Practice Address - Fax:541-416-2066
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health