Individual
TRACY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4100 VETERANS PKWY, MCHENRY, IL 60050-8350
(815) 385-6400
Mailing address
4100 VETERANS PKWY, MCHENRY, IL 60050-8350
(815) 385-6400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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