Individual
SAMANTHA JO LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
2240 PLYMOUTH RD APT 101, MINNETONKA, MN 55305-2348
(952) 270-8166
Mailing address
2240 PLYMOUTH RD APT 101, MINNETONKA, MN 55305-2348
(952) 270-8166
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
107278
MN
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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