Individual
MS. ELAINE NAOMI LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 RIDGE AVE, EVANSTON, IL 60201-2492
(847) 570-5020
Mailing address
2530 RIDGE AVE, EVANSTON, IL 60201-2492
(847) 570-5020
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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