Individual
LARISSA CLAIR BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2080 WOODDALE DR, WOODBURY, MN 55125-2924
(612) 201-2468
Mailing address
55 LIVINGSTON AVE APT 320, SAINT PAUL, MN 55107-5700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/27/2026
Last updated
03/27/2026
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