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Individual

ELISE ANN LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-4446
(505) 287-5213
Mailing address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-4446
(505) 287-5213

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2024-0822
NM

Other

Enumeration date
11/20/2015
Last updated
08/13/2024
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