Individual
JENNIFER LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2490
Mailing address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2490
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3334
WI
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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