Individual
JENNA HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2600
ID
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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