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General NPI Number Information
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NPI Number | 1376857953
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Entity Type | Individual
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Provider Name | MRS. JENNIFER LYNNE MISKO
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Gender | Female
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 28050 ROAD 148
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City | VISALIA
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State | CA
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Zip | 93292-9297
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Country | US
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Telephone | 559-747-3984
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Fax | 559-747-3642
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Provider Business Mailing Address
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Address Line | PO BOX 5091
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City | VISALIA
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State | CA
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Zip | 93278-5091
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Country | US
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Telephone | 559-747-3984
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Fax | 559-747-3642
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF67994
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License Number State | CA
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