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General NPI Number Information
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NPI Number | 1558031385
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Entity Type | Individual
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Provider Name | JENNAH STRATHAUSEN PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 201 W BROADWAY STE 2F
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City | COLUMBIA
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State | MO
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Zip | 65203-3842
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Country | US
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Telephone | 785-393-2315
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Fax |
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Provider Business Mailing Address
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Address Line | 818 ROLLINS RD
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City | COLUMBIA
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State | MO
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Zip | 65203-2850
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Country | US
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Telephone | 785-393-2315
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2021034427
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License Number State | MO
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