Individual
JENSEN SIROFCHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2570 TECHNICAL DR, MIAMISBURG, OH 45342-6107
(937) 847-8750
Mailing address
2570 TECHNICAL DR, MIAMISBURG, OH 45342-6107
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20211875-SP
OH
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0452342
—
OH
Enumeration date
09/14/2021
Last updated
06/09/2022
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