Individual
AMBER LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
448 W OAK ST, CHICAGO, IL 60610-2466
(703) 431-7055
Mailing address
448 W OAK ST, CHICAGO, IL 60610-2466
(703) 431-7055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.014135
IL
101YP2500X
Professional Counselor
Primary
180.014135
IL
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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