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Individual

NOEL LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D., L.P., LMFT

Contact information

Practice address
821 RAYMOND AVE, SUITE 440, SAINT PAUL, MN 55114-1503
(651) 642-9317
Mailing address
821 RAYMOND AVE, SUITE 440, SAINT PAUL, MN 55114-1503
(651) 642-9317

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP0822
MN
103TC0700X
Clinical Psychologist
Primary
LP0822
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1009939
PREFERRED ONE
MN
01
31B14ME
BLUE CROSS BLUE SHIELD
MN
01
31B15LA
BCBS INDIVIDUAL #
MN
01
61-91122
MEDICA
MN
01
HP18477
HEALTHPARTNERS
MN
01
PS1500
AMERICA'S PPO
MN
Enumeration date
12/16/2005
Last updated
09/11/2025
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