| Doctor Name: | MR. CHASE WILLIAM LARSEN |
| NPI Number: | 1609111673 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S. CF-SLP |
| License Number: | TSLP7981 |
| Business Practice Address: | 1355 S Higley Rd Bldg 5, Suite 111 Gilbert, AZ - 852964799 |
| Business Phone Number: | 4804744173 |
| Business Fax Number: | |
| Mailing Address: | Po Box 11476, CHANDLER |
| State: | AZ |
| Postal Code: | 852480008 |
| Phone Number: | 4802015787 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2012 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | TSLP7981 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| 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 |