Individual
MARY JACQUELINE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
80 ACOMA BLVD S STE 106, LAKE HAVASU CITY, AZ 86403-6926
(928) 706-5051
Mailing address
3445 KEARSAGE DR, LAKE HAVASU CITY, AZ 86406-9052
(928) 706-5051
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-26330
AZ
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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