| Doctor Name: | ANNA LISA JENSEN |
| NPI Number: | 1093954919 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | 2009000728 |
| Business Practice Address: | 301 Sovereign Ct Suite 211 Ballwin, MO - 630114441 |
| Business Phone Number: | 3144229924 |
| Business Fax Number: | |
| Mailing Address: | 301 Sovereign Ct, Suite 211 BALLWIN |
| State: | MO |
| Postal Code: | 630114441 |
| Phone Number: | 3144229924 |
| Fax Number: | |
| NPI Enumeration Date: | 02/17/2009 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2009000728 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |