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1649017914
JONATHAN MATTHEW LARSON
WICHITA, KS
NPI
1649017914
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: KS 03266)
Enumeration Date
2024-07-12
Last Update Date
2024-07-12
Business Address
JONATHAN MATTHEW LARSON MS
100 S MAIN ST STE 505
WICHITA, KS 67202-3738
Phone number: 316-688-8390
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Mailing Address
JONATHAN MATTHEW LARSON MS
110 N 127TH ST E APT 1231
WICHITA, KS 67206-2772
Phone number: 310-748-0355
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