Individual
REBECCA JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2235 E 25TH ST STE 160, IDAHO FALLS, ID 83404-7538
(208) 522-9812
(208) 522-9859
Mailing address
PO BOX 3051, IDAHO FALLS, ID 83403-3051
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC3877
ID
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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