Provider Demographics
NPI:1932698701
Name:JENSEN, ABIGAIL V (MS SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:V
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 CALDWELL LN
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4485
Mailing Address - Country:US
Mailing Address - Phone:605-484-5644
Mailing Address - Fax:
Practice Address - Street 1:2816 CALDWELL LN
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4485
Practice Address - Country:US
Practice Address - Phone:605-484-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist