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NPI Profile for JAIME L LARSON in WILLMAR, MN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Counselor |
101Y00000X |
| NPI # | 1073275053 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/07/2021 | |
| Last updated | 10/07/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JAIME L LARSON
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JAIME L LARSON