Individual
CHERI JO LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3868 WILLOW RIDGE DR, AMMON, ID 83406-5079
(929) 928-1920
Mailing address
3868 WILLOW RIDGE DR, AMMON, ID 83406-5079
(929) 928-1920
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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