Individual
ELISSA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NBC-HWC
Contact information
Practice address
156 SHARON DR, CANTON, GA 30115-9622
(770) 843-8192
Mailing address
156 SHARON DR, CANTON, GA 30115-9622
(770) 843-8192
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3991527
GA
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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