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Contact Information

MARLENA LARSON, PSY.D.
1320 WISCONSIN AVE
RACINE, WI53403-1978
 Phone: 262-687-2436
 Fax: 262-687-2495
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARLENA LARSON · (Female)

NPI # 1538154679
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 09/14/2005
Last updated 11/25/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 2512-057
  • WI Medicaid 40959700
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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