| Kellie J Jensen | |
|
729 Fort St Buffalo WY 82834-2316 | |
| (307) 217-1311 | |
| (307) 684-2182 |
| Full Name | Kellie J Jensen |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 729 Fort St, Buffalo, Wyoming |
| Authorized Official Name and Position | Kellie J Jensen (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3072171311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie J Jensen 729 Fort St Buffalo WY 82834-2316 Ph: (307) 217-1311 | Kellie J Jensen 729 Fort St Buffalo WY 82834-2316 Ph: (307) 217-1311 |
| NPI Number | 1023362035 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 10/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023362035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 661 (Wyoming) | Primary |
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