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NPI Code Detail

MEDICARE: JENNIFER DECKER LPC

MEDICARE: JENNIFER DECKER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorC1700257OH

General Provider Information

NPI Number : 1124532312
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DECKER LPC
Provider Business Mailing Address
First Line : 1429 MOLER AVE APT B
Second Line :
City : KETTERING
State : OH
Zip : 45420-2045
Country : US
Telephone Number : 937-361-9715
Fax Number :
Provider Business Practice Location Address
First Line : 1785 BIG HILL RD
Second Line :
City : DAYTON
State : OH
Zip : 45439-2219
Country : US
Telephone Number : 937-264-0084
Fax Number : 937-264-0084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2017
Last Update Date : 11/27/2017

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