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Individual
MR. DUSTIN ADAM LARSON
Active
Individual
MR. DUSTIN ADAM LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001898
IA
235Z00000X
Speech-Language Pathologist
—
SD
Other
Enumeration date
09/04/2008
Last updated
05/26/2011
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