Individual
SAMANTHA JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
KGH CONSULTATION AND TREATMENT INC.,, 3113 WEST BELTLINE HWY, MADISON, WI 53713
(608) 819-6910
Mailing address
KGH CONSULTATION AND TREATMENT INC, 1161 LAKE COOK ROAD, DEERFIELD, IL 60015-5649
(224) 284-2240
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-204995
WI
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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