Individual
DR. JON NORMAN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7840 VINEWOOD LANE, MAPLE GROVE, MN 55369-4655
(763) 236-0287
(763) 420-5531
Mailing address
7840 VINELAND LANE N, MAPLE GROVE, MN 55369-4655
(763) 236-0287
(763) 420-5531
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP5024
MN
103TC2200X
Clinical Child & Adolescent Psychologist
PSY12343
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336118603
NPI
MN
Enumeration date
03/17/2006
Last updated
02/17/2011
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