Individual
MRS. CATHERINE RENE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ILTYPE 10, LBS1
Contact information
Practice address
1806 W SCHOOL ST, APARTMENT 2, CHICAGO, IL 60657-2006
(773) 404-3069
Mailing address
1806 W SCHOOL ST, APARTMENT 2, CHICAGO, IL 60657-2006
(773) 404-3069
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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