| NPI | 1902207558 |
|---|---|
| Former Name | STEPHANIE JENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: FL PT29485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 29485) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-03-31 |