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Individual

AMANDA SCHNIERLE LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
707 KENTUCKY ST, FAIRFIELD, CA 94533-5515
(707) 759-3716
Mailing address
8400 FUTURITY CT, ANTELOPE, CA 95843-5051
(916) 708-7472

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21099
CA

Other

Enumeration date
05/31/2015
Last updated
05/31/2015
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