Individual
CHERYL LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
10754 HWY 12, GLEN ELLEN, CA 95442-9784
(707) 235-3752
Mailing address
PO BOX 244, KENWOOD, CA 95452-0244
(707) 235-3752
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10017
CA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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