Individual
MARLENA SHAREA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
672 FRONT ST, LITITZ, PA 17543-1705
(717) 945-2555
Mailing address
672 FRONT ST, LITITZ, PA 17543-1705
(717) 945-2555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
25206213
PA
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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