Provider Demographics
NPI:1346841194
Name:JENSEN, EMILY A (AUD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:JENSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 SAINT ROSE PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3504
Mailing Address - Country:US
Mailing Address - Phone:702-792-6700
Mailing Address - Fax:
Practice Address - Street 1:3195 SAINT ROSE PKWY STE 210
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3504
Practice Address - Country:US
Practice Address - Phone:702-792-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-2884231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist