Individual
GRACE MARIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
853 S 400 E APT 6, SALT LAKE CITY, UT 84111-4356
(815) 491-9603
Mailing address
853 S 400 E APT 6, SALT LAKE CITY, UT 84111-4356
(815) 491-9603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9538215-3501
UT
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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