Individual
BETH A LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP (PSYCHOLOGIST)
Contact information
Practice address
7225 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5501
(612) 824-0974
Mailing address
4900 RUSSELL AVE S, MINNEAPOLIS, MN 55410-1915
(612) 824-0974
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3421
MN
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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