Individual
HALLIE NICOLE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2985 S MERIDIAN RD STE 140, MERIDIAN, ID 83642-8051
(208) 901-4888
Mailing address
2985 S MERIDIAN RD STE 140, MERIDIAN, ID 83642-8051
(208) 901-4888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801287622
SELECT HEALTH
—
Enumeration date
02/07/2022
Last updated
01/16/2023
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