Individual
TESSALA KEI LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
550 RIVER RD, EUGENE, OR 97404-3212
(510) 371-2878
Mailing address
1790 W 11TH AVE, EUGENE, OR 97402-3758
(510) 371-2878
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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