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1538478714
LARISSA K HUMISTON
WINTER PARK, FL
NPI
1538478714
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW9576)
Enumeration Date
2010-10-05
Last Update Date
2013-12-05
Business Address
-- LARISSA K HUMISTON MSW, LCSW
1414 GAY RD SUITE 205
WINTER PARK, FL 32789-2928
Phone number: 407-415-1175
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Mailing Address
-- LARISSA K HUMISTON MSW, LCSW
456 GALLBERRY ST
ALTAMONTE SPRINGS, FL 32714-2499
Phone number: 407-415-1175
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