Mary Larson's National Provider Identifier (NPI) Details
Mary Larson, lcsw
NPI: 1932368420
Enumeration Date: 2008-06-09
Last updated: 2008-06-09
Sole Proprietor: YES
Status: active
Postal Address: 2810 WHISTLER ST, WEST MELBOURNE, FL
Phone: 321-506-8524
Primary Practice Address: 2810 WHISTLER ST, WEST MELBOURNE, FL
Practice's phone: 321-506-8524