Individual
JENNIFER MARIA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
31979 N FISH LAKE RD, ROUND LAKE, IL 60073-9517
(847) 201-7066
Mailing address
31979 N FISH LAKE RD, ROUND LAKE, IL 60073-9517
(847) 201-7066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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