| Doctor Name: | DIANE M LARSON |
| NPI Number: | 1023231727 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | SW4178 |
| Business Practice Address: | 14144 Nephron Ln Hudson, FL - 346676504 |
| Business Phone Number: | 7272513832 |
| Business Fax Number: | 7272513832 |
| Mailing Address: | 800 Chesapeake Dr Lot 18, TARPON SPRINGS |
| State: | FL |
| Postal Code: | 346892504 |
| Phone Number: | 7279406055 |
| Fax Number: | 7279406055 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 05/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW4178 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |