| NPI | 1952058828 |
|---|---|
| Former Name | KRISTEN MICHELLE LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149025250) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150104697) |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2023-02-23 |