Individual
SHYLENE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1600 S MAIN ST, LEBANON, OR 97355-3109
(541) 451-5932
Mailing address
1600 S MAIN ST, LEBANON, OR 97355-3109
(541) 451-5932
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
—
—
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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