Individual provider · Type 1 NPI

Carly Jensen

Developmental Therapist · New Lenox, IL

NPI number 1295008167 Active

Practice location

174 Haines Avenue
New Lenox, IL 60451-1602

Call (815) 603-8414 Map

Mailing address

174 Haines Ave
New Lenox, IL 60451-1602

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000X2381813 (IL)

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1295008167

Carly Jensen's National Provider Identifier is 1295008167, issued on Feb 22, 2012. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in New Lenox, IL. The record was last updated on Nov 19, 2012.