Individual
DR. GREGG A JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
6353 CENTER DRIVE, STE 204, NORFOLK, VA 23502-4808
(757) 455-8923
(757) 461-1641
Mailing address
6353 CENTER DRIVE, STE 204, NORFOLK, VA 23502-4808
(757) 455-8923
(757) 461-1641
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
081000963
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007710011
—
VA
Enumeration date
08/09/2006
Last updated
11/22/2011
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