Provider Demographics
NPI:1154139905
Name:JENSEN, KAEL (MA, BS, NBC-HWC, CMT)
Entity type:Individual
Prefix:
First Name:KAEL
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MA, BS, NBC-HWC, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 MILLER CREST LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-6829
Mailing Address - Country:US
Mailing Address - Phone:651-442-1308
Mailing Address - Fax:
Practice Address - Street 1:12445 55TH ST N STE A
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-7402
Practice Address - Country:US
Practice Address - Phone:651-442-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach