Individual
EMMA GRACE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4801 SARGENT RD NE, WASHINGTON, DC 20017-2841
(202) 650-6361
(202) 250-6362
Mailing address
4801 SARGENT RD NE, WASHINGTON, DC 20017-2841
(202) 650-6361
(202) 250-6362
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
06938
MD
103T00000X
Psychologist
Primary
PSY200001381
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47037660624
—
NE
05
—
47037660631
—
NE
Enumeration date
05/15/2020
Last updated
03/04/2024
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