Provider Demographics
NPI:1710474812
Name:JENSEN, LINDA ANN (OTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 WINDWHEEL POINT DR
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9314
Mailing Address - Country:US
Mailing Address - Phone:517-304-5700
Mailing Address - Fax:
Practice Address - Street 1:644 S HOWELL
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169
Practice Address - Country:US
Practice Address - Phone:734-954-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001207225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist