Organization
ADVANCE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M JENSEN (SPEECH-LANGUAGE PATHOLOGIST)
(651) 784-7007
Entity
Organization
Contact information
Practice address
6776 LAKE DR, LINO LAKES, MN 55014-1191
(651) 784-7007
Mailing address
3877 BIG TIMBER TRL, EAGAN, MN 55123-2474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9165
MN
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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