Individual
MELISSA L LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
275 E SOUTH TEMPLE STE 100, SALT LAKE CITY, UT 84111-1242
(909) 957-5492
Mailing address
275 E SOUTH TEMPLE STE 100, SALT LAKE CITY, UT 84111-1242
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10913473-3502
UT
Other
Enumeration date
08/07/2018
Last updated
10/28/2019
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