Individual
MS. DEBRA K LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1436 S LINCOLN ST, SHAWANO, WI 54166-3427
(715) 526-6111
Mailing address
1436 S LINCOLN ST, SHAWANO, WI 54166-3427
(715) 526-6111
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3328-154
WI
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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