Provider Demographics
NPI:1194278739
Name:DORSCHUG, JENNIFER (LISWS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DORSCHUG
Suffix:
Gender:F
Credentials:LISWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 MCPICKEN DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-4905
Mailing Address - Country:US
Mailing Address - Phone:513-706-6904
Mailing Address - Fax:513-354-7280
Practice Address - Street 1:7162 READING RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3838
Practice Address - Country:US
Practice Address - Phone:513-354-1302
Practice Address - Fax:513-354-7280
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0800755SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical