Individual
MELISSA LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 FAIR ST, BRISTOL, CT 06010-5531
(860) 589-2923
Mailing address
47 UNCAS DR, AMSTON, CT 06231-1331
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4605
CT
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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