Individual
FREDRIK LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 700 E, SUITE 2A, SALT LAKE CITY, UT 84102
(801) 935-4171
Mailing address
515 700 E, SUITE 2A, SALT LAKE CITY, UT 84102
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/02/2014
Last updated
12/07/2022
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