Individual
LARISSA CHANDRIMA KAIULANI PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1780 OLD HIGHWAY 50 E STE 102, UNION, MO 63084-3397
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2021005305
MO
Other
Enumeration date
02/16/2021
Last updated
02/08/2023
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