Larson, Marlena
Larson, Marlena is an individual health care provider with primary practice located at 1320 Wisconsin Ave , Racine WI 53403-1978. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Larson, Marlena can be contacted via phone (262) 687-2436.Contact Information
Primary practice address
1320 Wisconsin Ave
Racine WI 53403-1978
Phone: (262) 687-2436
Fax: (262) 687-2495
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2512-057 | Wisconsin |
Profile Details
| NPI number | 1538154679 |
|---|---|
| LBN Legal business name | Larson, Marlena |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2005 |
| Last updated | Nov 25th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538154679 | NPPES |
| Wisconsin | MEDICAID | 40959700 |
Popular Providers
-
Zimmel, Tammy Lynn
3701 Durand Ave Suite 325, Racine WI 53405-4458 -
Hayden, D Martin
840 Lake Ave Racine, Racine WI 53403-1566 -
Cohen-Smith, Deborah Lynn
1320 Wisconsin Ave , Racine WI 53403-1978 -
Wendorf, Anthony Donald
840 Lake Avenue, Suite 101 , Racine WI 53403-1550 -
Degenhart, Joyce Shirley
11 Greenwood Ct , Racine WI 53402-1248 -
Kinkade, Russell William
6214 Washington Avenue Suite C 10, Racine WI 53406 -
Ladhani, Shamin Catherine Jaffer
1320 Wisconsin Ave , Racine WI 53403-1978 -
Peterson, Jill M
3801 Spring St , Racine WI 53405-1667