Doctor Name: | THERESA LARSSON |
NPI Number: | 1306141205 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | LL 60200889 |
Business Practice Address: | 16030 Bothell Everett Hwy Ste 140 Mill Creek, WA - 980121273 |
Business Phone Number: | 4253389005 |
Business Fax Number: | 4253370931 |
Mailing Address: | 16030 Bothell Everett Hwy Ste 140, MILL CREEK |
State: | WA |
Postal Code: | 980121273 |
Phone Number: | 4253389005 |
Fax Number: | 4253370931 |
NPI Enumeration Date: | 01/24/2011 |
NPI Last Update Date: | 01/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL 60200889 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |