Individual
JULIA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
6614 27TH ST S, FARGO, ND 58104-7966
(701) 491-8685
Mailing address
6614 27TH ST S, FARGO, ND 58104-7966
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
ALPP-358870
MA
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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