Individual
MRS. JENA COSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
5348 LAMME RD, MORAINE, OH 45439-3215
(937) 534-4651
(937) 522-8799
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1302527
OH
363A00000X
Physician Assistant
Primary
50.008345
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186107
—
OH
Enumeration date
06/20/2013
Last updated
01/25/2024
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