Provider Demographics
NPI:1689483257
Name:OSWALD, JENNIFER INGLIS (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:INGLIS
Last Name:OSWALD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 SUMTER DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-2951
Mailing Address - Country:US
Mailing Address - Phone:770-315-6354
Mailing Address - Fax:
Practice Address - Street 1:732 KENNESAW AVE NW STE 250
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9420
Practice Address - Country:US
Practice Address - Phone:770-315-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health