Individual
LARISA CLARK NIGHTINGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
2200 SW GAGE BLVD, TOPEKA, KS 66622-0001
(785) 350-3111
Mailing address
1700 VERMONT ST, LAWRENCE, KS 66044-4278
(785) 842-5732
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW 1559
KS
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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