Provider Demographics
NPI:1215366794
Name:GANSHORN, JENNIFER LYNN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:GANSHORN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:GALONSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:343 S MAIN ST STE 211
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2138
Mailing Address - Country:US
Mailing Address - Phone:734-412-7400
Mailing Address - Fax:
Practice Address - Street 1:343 S MAIN ST STE 211
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2138
Practice Address - Country:US
Practice Address - Phone:734-412-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical