Individual
MS. CAROLYN MICHELLE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2243 N LISTER AVE, APT 302, CHICAGO, IL 60614-9016
(309) 310-5961
Mailing address
2243 N LISTER AVE APT 302, CHICAGO, IL 60614-6395
(309) 310-5961
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146008841
IL
Other
Enumeration date
05/29/2011
Last updated
05/29/2011
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