Individual
MR. MATTHEW LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
16 12TH AVE S, SUITE 201, NAMPA, ID 83651-3936
(208) 489-6866
(208) 475-6025
Mailing address
1550N CRESTMONT DR A, MERIDIAN, ID 83642-2177
(208) 288-4200
(208) 288-4279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW--33509
ID
Other
Enumeration date
01/09/2013
Last updated
12/10/2015
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