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General NPI Number Information
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NPI Number | 1043028038
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Entity Type | Individual
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Provider Name | RACHEL HOPE JENSEN
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Gender | Female
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Dates
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Enumeration Date | 12/21/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 3717 S GRANGE AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57105-6329
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Country | US
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Telephone | 605-782-9871
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Fax |
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Provider Business Mailing Address
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Address Line | 4106 W VALHALLA BLVD APT 28
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City | SIOUX FALLS
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State | SD
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Zip | 57106-3736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT11631
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License Number State | SD
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