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1689423121
LISA K LARSEN
CHUBBUCK, ID
NPI
1689423121
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LMSW-44463)
Enumeration Date
2024-05-16
Last Update Date
2024-05-16
Business Address
LISA K LARSEN LMSW
265 E CHUBBUCK RD
CHUBBUCK, ID 83202-5055
Phone number: 208-237-1711
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Mailing Address
LISA K LARSEN LMSW
265 E CHUBBUCK RD
CHUBBUCK, ID 83202-5055
Phone number: 208-237-1711
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