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General NPI Number Information
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NPI Number | 1083216063
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Entity Type | Individual
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Provider Name | MICHAELA ANN JENS
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Gender | Female
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 4309 UNIVERSITY AVE
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City | DES MOINES
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State | IA
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Zip | 50311-3423
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Country | US
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Telephone | 515-996-5935
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Fax |
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Provider Business Mailing Address
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Address Line | 7051 BROOKVIEW DR
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City | URBANDALE
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State | IA
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Zip | 50322-8006
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Country | US
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Telephone | 402-650-6568
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 099610
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License Number State | IA
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