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Individual

MRS. MEGAN SUSANNE LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW, ACSW

Contact information

Practice address
3220 MIDDLE DR, COLUMBUS, IN 47203-4426
(812) 378-4428
(812) 378-4427
Mailing address
3220 MIDDLE DR, COLUMBUS, IN 47203-4426
(812) 378-4428
(812) 378-4427

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004808A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000381518
ANTHEM
IN
01
076965
SIHO
IN
Enumeration date
01/25/2007
Last updated
07/08/2007
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