Provider Demographics
NPI:1255830485
Name:JENNIFER CULVER, PH.D., LLC
Entity Type:Organization
Organization Name:JENNIFER CULVER, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:CULVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-883-3688
Mailing Address - Street 1:455 E EISENHOWER PKWY STE 15
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3321
Mailing Address - Country:US
Mailing Address - Phone:734-726-4595
Mailing Address - Fax:
Practice Address - Street 1:455 E EISENHOWER PKWY STE 15
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3321
Practice Address - Country:US
Practice Address - Phone:734-726-4595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty