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1265078935
MARY AMANDA JENSEN
RIGBY, ID
NPI
1265078935
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 11526)
Enumeration Date
2019-11-18
Last Update Date
2019-11-18
Business Address
MARY AMANDA JENSEN CADC
3990 E 20 N
RIGBY, ID 83442-5818
Phone number: 208-390-7373
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Mailing Address
MARY AMANDA JENSEN CADC
3990 E 20 N
RIGBY, ID 83442-5818
Phone number: 208-390-7373
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