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General NPI Number Information
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NPI Number | 1083824007
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Entity Type | Individual
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Provider Name | MS. PATRICIA E JENSEN
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 595 VALLEY ST
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City | WILLIMANTIC
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State | CT
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Zip | 06226-1901
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Country | US
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Telephone | 860-450-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 76 CHAPMAN ST FL 2
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City | PUTNAM
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State | CT
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Zip | 06260-2324
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Country | US
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Telephone | 860-963-8907
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 001270
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License Number State | CT
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