| NPI | 1346020740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALORY L LARSON A RN P, Pmhnp Bc 563-217-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2024-04-17 |