Individual
MS. JENNIFER MARY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
9030 W HADLEY ST, MILWAUKEE, WI 53222-4634
(414) 479-9923
Mailing address
6273 UPPER PKWY N, WAUWATOSA, WI 53213-2429
(414) 257-4681
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2550-154
WI
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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