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Contact Information

MALISSA A LARSON
192 RICHMOND AVE
BUFFALO, NY14222-2112
 Phone: 646-823-5401
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Doula

374J00000X
 

Exercise & Sports

103TE1100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MALISSA A LARSON · (Female)

NPI # 1982175824
Status Active
Credentials
Entity Individual
Enumeration date 12/17/2018
Last updated 06/11/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers Not Available
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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