Individual
MRS. KELLY SUE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5294 SE MITCHELL LN, STUART, FL 34997-1573
(772) 215-7993
Mailing address
5294 SE MITCHELL LN, STUART, FL 34997-1573
(772) 215-7993
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
SW2850
FL
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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