Individual
LISA MARIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1941 S 42ND ST, OMAHA, NE 68105-2939
(402) 346-5220
Mailing address
1941 S 42ND ST, OMAHA, NE 68105-2939
(402) 346-5220
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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