PHYLLIS K. JENSEN, PSY.D.,L.L.C.
Managed Care Organizations at Venetia Bay Blvd, Venice, FL

License number
Florida PY6912
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: DR. PHYLLIS K. JENSEN PSY.D.
Title: PSYCHOLOGIST
Phone: (941) 485-0854
Address
Address
871 Venetia Bay Blvd SUITE 360, Venice, FL 34285
National Provider ID: 1306002803
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about PHYLLIS K. JENSEN, PSY.D.,L.L.C. at bizstanding.com

PHYLLIS K. JENSEN, PSY.D., LLC

871 Venetia Bay Blvd SUITE 360, Venice, FL 34285

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
May 28, 2008
Inactive since:
Sep 27, 2013
State ID:
L08000052932
Business type:
Florida Limited Liability Company
Manager:
Phyllis K Jensen Manager, inactive, 871 Venetia Bay Blvd, Venice, FL 34285 (Physical)
Agent:
Phyllis Jensen,871 Venetia Bay Blvd SUITE 360, Venice, FL 34285 (Physical)
EIN:
35-2349061

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