Individual
MS. ALICE J LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS STUDENT
Contact information
Practice address
2700 SIMPSON AVENUE, STE. 101, ABERDEEN, WA 98520
(360) 612-0012
(360) 532-0670
Mailing address
921 14TH AVENUE, LONGVIEW, WA 98632
(360) 423-0203
(360) 577-0269
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
60878870
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2107606
—
WA
Enumeration date
12/16/2009
Last updated
02/05/2019
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