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1386241511
KELLY JENSEN
BUFFALO, NY
NPI
1386241511
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: GU 827461)
Enumeration Date
2020-10-01
Last Update Date
2020-10-01
Business Address
KELLY JENSEN ICADC
255 DELAWARE AVE STE 3000
BUFFALO, NY 14202-2016
Phone number: 716-842-0440
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Mailing Address
KELLY JENSEN ICADC
255 DELAWARE AVE STE 3000
BUFFALO, NY 14202-2016
Phone number: 716-842-0440
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