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1669467577
DIANTHA JEAN LARSON
WATERTOWN, SD
NPI
1669467577
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: SD 3085)
Enumeration Date
2005-09-16
Last Update Date
2007-07-08
Business Address
Mrs. DIANTHA JEAN LARSON CCDC T
123 19TH ST NE
WATERTOWN, SD 57201-2823
Phone number: 605-886-0123
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Mailing Address
Mrs. DIANTHA JEAN LARSON CCDC T
PO BOX 1030
WATERTOWN, SD 57201-6030
Phone number: 605-886-0123
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