| NPI | 1710310362 |
|---|---|
| Former Name | JESSICA E LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 73750) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW28601) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2022-05-27 |