NPI | 1659326262 |
---|---|
Former Name | KAREN LARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC10962) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT10163) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2007-07-08 |