Individual
DR. LEOTA I LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LICENSE PSYCHOLO
Contact information
Practice address
17 S RIVER, SUITE 254, JANESVILLE, WI 53548
(608) 755-5260
(608) 755-5267
Mailing address
17 S RIVER, SUITE 254, JANESVILLE, WI 53548
(608) 755-5260
(608) 755-5267
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1808
WI
Other
Enumeration date
06/20/2006
Last updated
07/20/2010
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