| NPI | 1710217708 |
|---|---|
| Former Name | CHRISTINE MARIE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016521) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS016521) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2025-05-01 |