Organization
GERALD E. JENSEN, JR.
Active
Other names
Cedarbrook Counseling LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY E. JENSEN MA, LP (DIRECTOR)
(218) 822-3736
Entity
Organization
Contact information
Practice address
6980 FAIRVIEW RD, SUITE 110, BAXTER, MN 56425-7836
(218) 822-3736
(218) 822-3761
Mailing address
PO BOX 2633, BAXTER, MN 56425-2633
(218) 822-3736
(218) 822-3761
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 4642
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
555519100
—
MN
Enumeration date
05/27/2005
Last updated
02/10/2009
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