Individual
KELLY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 5TH ST W, STE. 1, BOTTINEAU, ND 58318-1204
(701) 228-3613
(701) 228-3600
Mailing address
314 5TH ST W, STE. 1, BOTTINEAU, ND 58318-1204
(701) 228-3613
(701) 228-3600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1627
ND
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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