Individual
LARISSA MARIE SPOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCA
Contact information
Practice address
6608 SIX FORKS RD STE 204, RALEIGH, NC 27615-6522
(919) 514-3566
Mailing address
3361 WILLS GROVE LN APT 305, RALEIGH, NC 27615-8070
(610) 730-2723
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A14996
NC
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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