Individual
CHRISTA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1261 ANTELOPE DR UNIT E, SYRACUSE, UT 84075-1204
(801) 638-1932
Mailing address
3323 W 3785 S, WEST HAVEN, UT 84401-6607
(801) 638-1932
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13417402-3502
UT
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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