Doctor Name: | JOLENE JENSEN |
NPI Number: | 1144526617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC-PROVISIONAL |
License Number: | T-0136581 |
Business Practice Address: | 735 Don Pasqual Rd Nw Los Lunas, NM - 870318493 |
Business Phone Number: | 5058653359 |
Business Fax Number: | |
Mailing Address: | 325 Cardenas Dr Ne, ALBUQUERQUE |
State: | NM |
Postal Code: | 871081711 |
Phone Number: | 5052642109 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2011 |
NPI Last Update Date: | 02/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | T-0136581 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |