Individual
KRISTA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7910 KINGSTON DR, WAXHAW, NC 28173-9002
(980) 218-0515
Mailing address
5621 CLOSEBURN RD, CHARLOTTE, NC 28210-3007
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11953
NC
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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