Individual
MS. KATHLEEN MARIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1620 N 7TH ST, RAPID CITY, SD 57701-0511
(605) 343-4958
Mailing address
1620 N 7TH ST, RAPID CITY, SD 57701-0511
(605) 343-4958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
162A
SD
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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