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Individual

JUSTINE JULIA LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8630 FENTON ST. SUITE 1200, COMMUNITY CLINIC, INC., SILVER SPRING, MD 20910
(301) 585-1250
(301) 585-6289
Mailing address
8630 FENTON ST. SUITE 1200, COMMUNITY CLINIC, INC., SILVER SPRING, MD 20910
(301) 585-1250
(301) 585-6289

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101249483
VA
2084P0804X
Child & Adolescent Psychiatry Physician
0101249483
VA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D63655
MD

Other

Enumeration date
02/27/2007
Last updated
12/09/2014
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