| Doctor Name: | MS. HEIDI MALIA LARSSON |
| NPI Number: | 1871825026 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | CP00006265 |
| Business Practice Address: | 1048 W James St Ste 101 Kent, WA - 980324600 |
| Business Phone Number: | 2067159223 |
| Business Fax Number: | |
| Mailing Address: | 24658 8th Ave S, DES MOINES |
| State: | WA |
| Postal Code: | 981983854 |
| Phone Number: | 2067159223 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2010 |
| NPI Last Update Date: | 06/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | CP00006265 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |