Individual
PAULA W LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2631 SOUTH PACKERLAND DR, SUITE 104 F, GREEN BAY, WI 54313-4130
(920) 884-1144
(920) 336-5959
Mailing address
2631 SOUTH PACKERLAND DR, SUITE 104F, GREEN BAY, WI 54313-4130
(920) 884-1144
(920) 336-5959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1639123
WI
Other
Enumeration date
11/01/2006
Last updated
08/06/2009
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