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Individual

MRS. MELISSA RUBY JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 399-7832
Mailing address
250 E 22ND ST, APT 103, OGDEN, UT 84401-1533
(801) 510-8825

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
10981190-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2260022408
RAILROAD MEDICARE
UT
05
876000308007
UT
Enumeration date
04/23/2015
Last updated
01/14/2021
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