Individual
MELISSA GORONI LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
111 HUNDERTMARK RD STE 205N, CHASKA, MN 55318-1586
(952) 903-1350
(952) 426-3856
Mailing address
9400 ZANE AVE N, BROOKLYN PARK, MN 55443-1814
(763) 762-8800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
26844
MN
1041C0700X
Clinical Social Worker
26844
MN
Other
Enumeration date
03/04/2021
Last updated
11/21/2024
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