| NPI | 1730637646 |
|---|---|
| Former Name | HALEY LARAE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1496) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 105234) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2020-09-29 |