Individual
MR. CHASE WILLIAM LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
2451 E BASELINE RD STE 420, GILBERT, AZ 85234-2472
(480) 474-4173
Mailing address
PO BOX 11476, CHANDLER, AZ 85248-0008
(480) 201-5787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP7981
AZ
Other
Enumeration date
12/03/2012
Last updated
04/05/2018
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