Individual
THERESA LYNN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
300 CEDAR ST, TARKIO, MO 64491-1174
(660) 736-4116
Mailing address
19539 215TH STREET, ROCK PORT, MO 64482
(660) 253-0924
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009006116
MO
Other
Enumeration date
03/17/2009
Last updated
03/17/2009
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