Individual
MS. KATHY JEAN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
107 E BECKERT RD, NEW LONDON, WI 54961-2509
(920) 982-9371
Mailing address
635 S NASH ST, HORTONVILLE, WI 54944-9485
(920) 858-5696
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4900-27
WI
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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