Individual
AMY JO JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2411 W 110TH ST, BLOOMINGTON, MN 55431-3926
(612) 709-3979
Mailing address
2411 W 110TH ST, BLOOMINGTON, MN 55431-3926
(612) 709-3979
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
104240
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104240
OCCUPATIONAL THERAPY PRACTITIONER
MN
01
—
296222
NBCOT BOARD CERTIFICATION
—
Enumeration date
10/09/2012
Last updated
02/18/2013
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