Individual
JENNIFER THAETE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-4545
(614) 722-4575
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2639
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35.147220
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005037
—
OH
Enumeration date
03/19/2019
Last updated
04/09/2025
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