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1477243731
MATTIE ROSE LARSON
LOS ANGELES, CA
NPI
1477243731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-05-10
Last Update Date
2023-05-10
Business Address
MATTIE ROSE LARSON
8831 VENICE BLVD
LOS ANGELES, CA 90034-3223
Phone number: 310-204-5200
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Mailing Address
MATTIE ROSE LARSON
1251 LINDA ROSA AVE
LOS ANGELES, CA 90041-2316
Phone number: 310-497-9550
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