Individual
MRS. ELIZABETH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12 MOHAWK ST, TUPPER LAKE, NY 12986-1028
(518) 359-7518
Mailing address
12 MOHAWK ST, TUPPER LAKE, NY 12986-1028
(518) 359-7518
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001996-1
NY
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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