| Doctor Name: | MRS. MARIA G JENSEN |
| NPI Number: | 1245408400 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, ICADC |
| License Number: | N-15573 |
| Business Practice Address: | 2975 Overland Ave Burley, ID - 833183231 |
| Business Phone Number: | 2088782600 |
| Business Fax Number: | 2088781336 |
| Mailing Address: | 2975 Overland Ave, BURLEY |
| State: | ID |
| Postal Code: | 833183231 |
| Phone Number: | 2088782600 |
| Fax Number: | 2088781336 |
| NPI Enumeration Date: | 02/11/2008 |
| NPI Last Update Date: | 02/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | N-15573 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |