Individual
DANIELLE MARIANNA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
1017 JEFFERSON ST, PEKIN, IL 61554-1640
(217) 416-3101
Mailing address
1017 JEFFERSON ST, PEKIN, IL 61554-1640
(217) 416-3101
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.006671
IL
Other
Enumeration date
12/21/2015
Last updated
09/09/2024
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