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Individual

MRS. REBECCA LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW LCSW

Contact information

Practice address
2111 EXCHANGE ST, ASTORIA, OR 97103-3329
(503) 338-7524
(503) 338-4019
Mailing address
364 SW KALMIA AVE, WARRENTON, OR 97146-7356
(928) 246-5100

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
L7575
OR

Other

Enumeration date
01/23/2009
Last updated
09/23/2019
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