Individual
THERESA MICHEL JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN CAC III
Contact information
Practice address
650 EAST WALNUT, ELIZABETH, CO 80107
(303) 646-4519
(970) 522-4211
Mailing address
211 W MAIN ST, STERLING, CO 80751-3168
(970) 522-4549
(970) 522-4211
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2878
CO
164W00000X
Licensed Practical Nurse
15108
CO
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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