Individual
TAMMY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5358 E BASELINE RD, MESA, AZ 85206-4716
(480) 699-9624
Mailing address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP9228
AZ
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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