Healthcare Provider Details

I. General information

NPI: 1396145579
Provider Name (Legal Business Name): JENNIFER ELIZABETH SYKES FROHNE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ELIZABETH SYKES PH.D.

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PORTLAND ST
COLUMBIA MO
65201-6521
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-6052
  • Fax: 573-884-1151
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2016016853
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: