Individual
ANNA LISETTE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515A W BUTLER RD, GREENVILLE, SC 29607-4833
(864) 757-9918
Mailing address
515A W BUTLER RD, GREENVILLE, SC 29607-4833
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
9114
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
10/07/2021
Last updated
06/11/2025
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