Individual
HALEIGH NICOLE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSDH, RDH, PHDHP
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-5252
(814) 274-5253
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-5252
(814) 274-5253
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
074674
PA
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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