Individual
MISS KAITLYN HANNA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2842 S BUSINESS DR, SHEBOYGAN, WI 53081-6518
(920) 547-3639
Mailing address
1401 S 23RD ST, SHEBOYGAN, WI 53081-5015
(920) 627-9100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
7555-226
WI
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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