Individual
KAYLEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 W DUNLAP AVE STE 100, PHOENIX, AZ 85021-2813
(602) 325-2485
Mailing address
996 ROYAL MARCO WAY, MARCO ISLAND, FL 34145-1829
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
Y5154285
CA
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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