Individual
EMILY RUTH LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
22365 BARTON RD STE 104, GRAND TERRACE, CA 92313-5037
(909) 824-2899
Mailing address
25342 LAWTON AVE, LOMA LINDA, CA 92354-3689
(701) 269-3077
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
23665
CA
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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