Kellie J Jensen

NPI #1023362035 in Buffalo, Wyoming

Provider Information

NPI Number: 1023362035
Entity Type: Organization
Organization Name: Kellie J Jensen
Primary Specialty: Social Worker - Clinical
Enumeration Date: Oct 30, 2012
Last Updated: Oct 30, 2012

Practice Location

Address: 729 FORT ST
City: Buffalo
State: Wyoming
ZIP Code: 82834-2316
Phone: (307) 217-1311

Authorized Official

Name: KELLIE J JENSEN, LCSW
Title: LICENSED CLINICAL SOCIAL WORKER
Phone: (307) 217-1311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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