Individual
MS. LESLIE ANNE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1141 E 3900 S, #250-A, SALT LAKE CITY, UT 84124-1215
(801) 284-4915
(801) 284-4901
Mailing address
1141 E 3900 S, #250-A, SALT LAKE CITY, UT 84124-1215
(801) 284-4915
(801) 284-4901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
136415-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136415-3501
DOPL NUMBER
UT
Enumeration date
01/24/2006
Last updated
08/08/2012
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