Provider Demographics
NPI:1942516109
Name:SOELKE, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SOELKE
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 1:100 SAW MILL RD
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5592
Mailing Address - Country:US
Mailing Address - Phone:765-742-4848
Mailing Address - Fax:765-477-9905
Practice Address - Street 1:100 SAW MILL RD
Practice Address - Street 2:SUITE 3200
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5592
Practice Address - Country:US
Practice Address - Phone:765-742-4848
Practice Address - Fax:765-477-9905
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor