Individual
MS. KRISTINE UTE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
289 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23462-5493
(757) 385-0850
Mailing address
289 INDEPENDENCE BLVD STE 245, VIRGINIA BEACH, VA 23462-5491
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003802
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004945395
VIRGINIA PREMIER
VA
05
—
004945395
—
VA
01
—
193939
ANTHEM
VA
01
—
227021700
TRICARE
VA
01
—
O89688M
OPTIMA
VA
Enumeration date
10/24/2006
Last updated
09/12/2011
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