Individual
KRISTA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
750 N 200 W, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
750 N 200 W, PROVO, UT 84601-1677
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6606740-3501
UT
Other
Enumeration date
01/15/2008
Last updated
06/02/2009
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