Individual
SANDRA L LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
401 STAGELINE RD, HUDSON, WI 54016-7897
(715) 531-6760
Mailing address
1023 OAK ST, HUDSON, WI 54016-1435
(715) 386-9846
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1385125
WI
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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