Individual
MARIAM A JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMFT
Contact information
Practice address
2420 N WOODLAWN BLVD, BLDG 100 STE K, WICHITA, KS 67220-3960
(316) 779-4337
(316) 776-4509
Mailing address
2420 N WOODLAWN BLVD, BLDG 100 STE K, WICHITA, KS 67220-3960
(316) 779-4337
(316) 776-4509
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2997
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201165860B
—
KS
Enumeration date
08/09/2017
Last updated
11/13/2021
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