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Individual

DOUGLAS LYNN JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LICSW

Contact information

Practice address
1360 ENERGY PARK DR, SUITE 340, SAINT PAUL, MN 55108-5276
(651) 646-8985
(651) 646-3959
Mailing address
1360 ENERGY PARK DR, SUITE 340, SAINT PAUL, MN 55108-5276
(651) 646-8985
(651) 646-3959

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11374
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01009905
PREFERRED ONE
MN
05
2915201-00
MN
01
42G10JE
BCBS
MN
Enumeration date
08/28/2006
Last updated
09/24/2008
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