Individual
AMANDA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC, LPC, NCC
Contact information
Practice address
617 S PASADENA AVE APT 3, PASADENA, CA 91105-3012
(860) 490-8103
Mailing address
617 S PASADENA AVE APT 3, PASADENA, CA 91105-3012
(860) 490-8103
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8312
CA
Other
Enumeration date
01/14/2009
Last updated
08/16/2021
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