Individual
JAMIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, BCBA
Contact information
Practice address
12300 PERRY HWY, WEXFORD, PA 15090-8379
(724) 933-4673
Mailing address
142 OVERBROOK RD, VALENCIA, PA 16059-1108
(724) 766-9181
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
PA
106S00000X
Behavior Technician
RBT-17-44761
PA
Other
Enumeration date
08/15/2019
Last updated
02/01/2023
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