Individual
MRS. JENNIFER RANEE LAURIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYSP, LLP
Contact information
Practice address
1308 S MAIN ST, PLYMOUTH, MI 48170-2253
(734) 451-3440
(734) 451-8720
Mailing address
1308 S MAIN ST, PLYMOUTH, MI 48170-2253
(734) 451-3440
(734) 451-8720
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012770
MI
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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