Organization
GP JENSEN LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL H TANT (OFFICE MANAGER)
(757) 461-3313
Entity
Organization
Contact information
Practice address
6353 CENTER DR, STE 204, NORFOLK, VA 23502-4112
(757) 461-3313
(757) 461-8363
Mailing address
6353 CENTER DR, STE 204, NORFOLK, VA 23502-4112
(757) 461-3313
(757) 461-8363
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810000963
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093725160
INDIVIDUAL NPI NUMBER
VA
Enumeration date
04/25/2013
Last updated
04/24/2017
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