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Individual

KRISTA M LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
402 WASHINGTON ST, NORTHFIELD, MN 55057-5190
(507) 301-1982
(507) 786-3786
Mailing address
402 WASHINGTON ST, NORTHFIELD, MN 55057-5190
(507) 301-1982
(507) 786-3786

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14348
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
787623800
MN
Enumeration date
03/08/2007
Last updated
08/23/2019
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