Individual
HOLLIS MAURICE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
1930 E SOUTHERN AVE, TEMPE, AZ 85282-7518
(480) 456-0719
Mailing address
647 E MANOR DR, CHANDLER, AZ 85225-8432
(480) 254-8724
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4891
AZ
Other
Enumeration date
07/23/2008
Last updated
02/23/2018
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