| Doctor Name: | DR. JESSICA LYNN BRUMM-LARSON |
| NPI Number: | 1699089490 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, LPC, NCSP |
| License Number: | 9189 |
| Business Practice Address: | 5007 S Howell Ave Milwaukee, WI - 532076157 |
| Business Phone Number: | 4149624048 |
| Business Fax Number: | 4144812537 |
| Mailing Address: | 5800 N Bayshore Dr, B-230 GLENDALE |
| State: | WI |
| Postal Code: | 532174540 |
| Phone Number: | 4149624048 |
| Fax Number: | 4149624052 |
| NPI Enumeration Date: | 08/04/2010 |
| NPI Last Update Date: | 06/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 9189 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |