Individual
JESSICA M OSMUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
123 N OAKLAND AVE, GREEN BAY, WI 54303-2831
(920) 973-1008
Mailing address
955 S MAIN ST, MISHICOT, WI 54228-9528
(920) 973-1008
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
983-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027626
—
WI
Enumeration date
12/12/2012
Last updated
11/04/2021
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