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Individual

MRS. LAURA ANN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCCSLP

Contact information

Practice address
3839 W CAMELBACK RD, ALHAMBRA HIGH SCHOOL, PHOENIX, AZ 85019
(602) 764-6298
(602) 271-3497
Mailing address
1429 N PARSELL CIR, MESA, AZ 85203
(480) 655-1878

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0256
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
588684
AZ
Enumeration date
03/27/2007
Last updated
07/08/2007
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