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1053966069
SHANE JENSEN
MINNEAPOLIS, MN
NPI
1053966069
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 304481)
Enumeration Date
2019-08-06
Last Update Date
2019-08-06
Business Address
SHANE JENSEN
610 22ND AVE S
MINNEAPOLIS, MN 55454-1315
Phone number: 612-330-1170
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Mailing Address
SHANE JENSEN
610 22ND AVE S
MINNEAPOLIS, MN 55454-1315
Phone number:
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