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Individual

EMILY JEAN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21013 E JEFFERSON CIR, AURORA, CO 80013-7414
(720) 353-8939
Mailing address
1310 S MONACO PKWY APT A, DENVER, CO 80224-2064
15742207812

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0002807
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235Z00000X
CO
Enumeration date
05/23/2017
Last updated
05/23/2017
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