Doctor Name: | MS. TOSHA L LARSON |
NPI Number: | 1114041308 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | TLMLP1012 |
Business Practice Address: | 1010 Remington Plz Raymore, MO - 640838640 |
Business Phone Number: | 6608908186 |
Business Fax Number: | |
Mailing Address: | 1800 Community, CLINTON |
State: | MO |
Postal Code: | 647358804 |
Phone Number: | 6608908186 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 01/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | TLMLP1012 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |