Individual
MRS. JENNIFER KATHRYN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3754
(372) 703-3725
Mailing address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3754
(372) 703-3725
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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