Individual
CORRIE LEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1126
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LW60324692
WA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
04/05/2012
Last updated
10/08/2024
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