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NPI Code Detail

MEDICARE: THOMAS JENSEN

MEDICARE: THOMAS JENSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1679877104
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS JENSEN
Provider Business Mailing Address
First Line : 7310 SMOKE RANCH RD STE R
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0260
Country : US
Telephone Number : 702-646-6284
Fax Number : 702-646-6284
Provider Business Practice Location Address
First Line : 7310 SMOKE RANCH RD STE R
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0260
Country : US
Telephone Number : 702-646-6284
Fax Number : 702-646-6284
Authorized Official
Title or Position : MARRIAGE & FAMILY THERAPIST
Name : THOMAS R JENSEN
Credential : M.S.
Telephone Number : 702-646-6284
Provider Enumeration Date : 12/23/2010
Last Update Date : 12/23/2010

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