Organization
PHYLLIS K. JENSEN, PSY.D.,L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHYLLIS K. JENSEN PSY.D. (PSYCHOLOGIST)
(941) 485-0854
Entity
Organization
Contact information
Practice address
871 VENETIA BAY BLVD, SUITE 360, VENICE, FL 34285-8047
(941) 485-0854
(941) 480-9013
Mailing address
871 VENETIA BAY BLVD, SUITE 360, VENICE, FL 34285-8047
(941) 485-0854
(941) 480-9013
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
PY6912
FL
Other
Enumeration date
08/04/2008
Last updated
05/27/2009
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