Individual
EVELYN ANN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1110 MECHEM AVE, LAS CRUCES, NM 88005-3002
(505) 527-0335
Mailing address
1110 MECHEM AVE, LAS CRUCES, NM 88005-3002
(505) 527-0335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-2532
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H4119
—
NM
Enumeration date
11/01/2006
Last updated
07/08/2007
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