Individual
ALEXANDER LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
Mailing address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
(651) 280-3995
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304937
MN
101YP2500X
Professional Counselor
Primary
CC02773
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304937
LADC
MN
Enumeration date
12/26/2018
Last updated
01/12/2022
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