| NPI | 1548694920 |
|---|---|
| Other Name | AMY LOUISE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60399561) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60383474) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |