Individual
LISA G JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 SW 12TH ST, LAWTON, OK 73501-3810
(580) 351-0242
(580) 351-0282
Mailing address
102 SW 12TH ST, LAWTON, OK 73501-3810
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2370
OK
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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