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JENNIFER REBEKAH LARSON PHD

Clinical Neuropsychologist

Raleigh, North Carolina

Provider NPI: 1487665584

Provider Information:
 JENNIFER REBEKAH LARSON PHD
Gender: F
Sole Proprietor


Practice Location:
8406 SIX FORKS RD STE 101  RALEIGH, NC 27615 US
Tel: 919-473-6451  Fax: 844-584-4207

Business Mailing Address:
8406 SIX FORKS RD STE 101  RALEIGH, NC 27615 US
Tel: 919-473-6451  Fax: 844-584-4207

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
NC2648
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NC2648

Other Provider Identifiers:

IssuerNumberStateType
BCBS045GANC01
6000216NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS NC - Page 1

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