Individual
JENNIFER C LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
325 EAST EISENHOWER, SUITE 300, ANN ARBOR, MI 48108-5744
(734) 936-7052
Mailing address
3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301016395
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2013
Last updated
12/11/2015
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