Individual
LARRY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
911 18TH ST N, SAINT CLOUD, MN 56303-1203
(320) 650-1660
Mailing address
911 18TH ST N, SAINT CLOUD, MN 56303-1203
(320) 650-1660
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00681
MN
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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