Individual
MRS. DEBORAH DIANE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
645 3RD AVE SW, PINE CITY, MN 55063-1468
(320) 629-1362
(320) 629-3454
Mailing address
645 3RD AVE SW, PINE CITY, MN 55063-1468
(320) 629-1362
(320) 629-3454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301810
MN
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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