Individual
JENSEN NICOLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(714) 293-1662
Mailing address
2594 FLANDERS CT, BREA, CA 92821-4666
(714) 293-1662
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2679
ID
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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