Individual
ADELE ANN LARSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0005176
CO
103T00000X
Psychologist
Primary
PY61114401
WA
Other
Enumeration date
10/30/2019
Last updated
03/04/2021
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