Organization
JEFFREY D LARSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D LARSON LADC (CLINICAL DIRECTOR)
(612) 251-8206
Entity
Organization
Contact information
Practice address
700 RAYMOND AVE SUITE 130, ST. PAUL, MN 55114
(612) 895-1513
Mailing address
700 RAYMOND AVE SUITE 130, ST. PAUL, MN 55114
(612) 895-1513
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
10/03/2021
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