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General NPI Number Information
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NPI Number | 1417569476
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Entity Type | Individual
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Provider Name | REBECCA MAE JENSEN OTD, OTR/L, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 801 SE 5TH ST
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City | EAGLE GROVE
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State | IA
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Zip | 50533-2478
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Country | US
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Telephone | 515-448-4599
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 ORCHARD ST W APT 94
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98467-3804
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Country | US
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Telephone | 515-422-6766
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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 | 7206
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 128889
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 61090602
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License Number State | WA
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