Individual
SOPHIA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 WESTRAC DR S STE 400, FARGO, ND 58103-2356
(507) 280-9545
Mailing address
1202 WESTRAC DR S STE 400, FARGO, ND 58103-2356
(507) 280-9545
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
10/17/2023
Last updated
01/15/2024
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