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Contact Information

LEOTA I LARSON, PHD LICENSE PSYCHOLO
17 S RIVER
SUITE 254
JANESVILLE, WI53548
 Phone: 608-755-5260
 Fax: 608-755-5267
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LEOTA I LARSON · (Female)

NPI # 1518903566
Status Active
Credentials PHD LICENSE PSYCHOLO
Entity Individual
Enumeration date 06/20/2006
Last updated 07/20/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1808
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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