| NPI | 1417273376 |
|---|---|
| Former Name | ANDREA NICOLE LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2014-04-23 |