Deforest, Jennifer

Deforest, Jennifer is an sole proprietor health care provider with primary practice located at 3 Coventry Ln , Athens OH 45701-3717. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as her primary health care specialty. Deforest, Jennifer can be contacted via phone (740) 707-1691.

Contact Information

Primary practice address
3 Coventry Ln Athens OH 45701-3717
Fax:
Website:

Profile Details

NPI number 1548858939
LBN Legal business name Deforest, Jennifer
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2021
Last updated Jan 2nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548858939 NPPES
Ohio MEDICAID 0427093

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