Provider Demographics
NPI:1245858554
Name:POUSKA, JENNY LEEANN (MED)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:LEEANN
Last Name:POUSKA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 CIRCLE ROAD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7692
Mailing Address - Country:US
Mailing Address - Phone:864-421-3477
Mailing Address - Fax:
Practice Address - Street 1:104 TRADE ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-3428
Practice Address - Country:US
Practice Address - Phone:864-421-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health