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Individual

MRS. SUZANNE M LARSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
Mailing address
3856 W DAISY CREEK ST, MERIDIAN, ID 83642-7969
(208) 982-9796

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-7519
ID
101YM0800X
Mental Health Counselor
LPC-5615
ID

Other

Enumeration date
02/06/2015
Last updated
08/26/2020
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