Individual
MELISSA JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9070 N 29TH AVENUE, PHOENIX, AZ 85051
(855) 772-8847
Mailing address
160 S 200 E, SPANISH FORK, UT 84660-2128
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
05/27/2016
Last updated
05/03/2024
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