Provider Demographics
NPI:1487381836
Name:BIEKER, JENNA
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BIEKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:IN
Mailing Address - Zip Code:47454-0270
Mailing Address - Country:US
Mailing Address - Phone:812-723-3944
Mailing Address - Fax:812-723-7140
Practice Address - Street 1:307 S INDIANA AVE
Practice Address - Street 2:
Practice Address - City:ENGLISH
Practice Address - State:IN
Practice Address - Zip Code:47118-5851
Practice Address - Country:US
Practice Address - Phone:812-338-2924
Practice Address - Fax:812-338-3706
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99113188A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health