Healthcare Provider Details

I. General information

NPI: 1255830485
Provider Name (Legal Business Name): JENNIFER CULVER, PH.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E EISENHOWER PKWY STE 15
ANN ARBOR MI
48108-3321
US

IV. Provider business mailing address

455 E EISENHOWER PKWY STE 15
ANN ARBOR MI
48108-3321
US

V. Phone/Fax

Practice location:
  • Phone: 734-726-4595
  • Fax:
Mailing address:
  • Phone: 734-726-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER A CULVER
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 734-883-3688