| NPI | 1699370148 |
|---|---|
| Former Name | NICOLE K LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 3394) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN 3394) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304315) | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2024-02-27 |