Individual
JESSICA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 N 4TH AVE, PASCO, WA 99301-5257
(603) 499-5512
Mailing address
106 GRANDVIEW RD, LITTLETON, NH 03561-3440
(603) 499-5512
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992
OCCUPATIONAL THERAPY
—
Enumeration date
10/31/2022
Last updated
10/31/2022
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