Individual
AMY JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4545
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4545
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA12310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010202200
—
FL
05
—
016011300
—
FL
Enumeration date
10/30/2013
Last updated
03/03/2016
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