Individual
ELLIOTT ANNE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
724 ELK MOUNTAIN DR, SEVERANCE, CO 80550-4868
(970) 518-7028
Mailing address
724 ELK MOUNTAIN DR, SEVERANCE, CO 80550-4868
(970) 518-7028
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
704020008300
FIRST HEALTH
CO
Enumeration date
03/11/2022
Last updated
03/11/2022
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