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1255687190
LORI ANN LARSON
MODESTO, CA
NPI
1255687190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-07-30
Last Update Date
2014-10-07
Business Address
Miss LORI ANN LARSON
1235 MCHENRY AVE
MODESTO, CA 95350-5370
Phone number: 209-521-0063
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Mailing Address
Miss LORI ANN LARSON
2004 SEQUOIA ST
CERES, CA 95307-2531
Phone number: 209-538-8368
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