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NPI Code Detail

MEDICARE: JENSEN SCHALL

MEDICARE: JENSEN SCHALL
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
1103K00000XBehavior Analyst1-24-74129IN

General Provider Information

NPI Number : 1780261941
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENSEN SCHALL
Provider Business Mailing Address
First Line : 5125 DECATUR BLVD STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-7511
Country : US
Telephone Number : 317-813-4690
Fax Number :
Provider Business Practice Location Address
First Line : 5125 DECATUR BLVD STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-7511
Country : US
Telephone Number : 317-813-4690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 08/09/2024

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Directions to “ JENSEN SCHALL ” Practice Location

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