Jody B Larson is a Art Therapist in Green Bay, Wisconsin. Jody B Larson practices all healthcare services and medical treatments related to Art Therapist. The NPI Number for Jody B Larson is 1750590477. The last update date is 2016-04-13.
Jody B Larson's current location address is Po Box 22040, Green Bay, Wisconsin. You can contact this provider via phone number 9204457222 and fax number 9204457289. The mailing address for Jody B Larson is Po Box 22040, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jody B Larson |
|---|---|
| Address | Po Box 22040, Green Bay, Wisconsin |
| Phone Number | 9204457222 |
| Fax Number | 9204457289 |
| Sole Proprietor | N |
| Credentials | LPC, ATRL |
NPI Number Detail
| NPI Number | 1750590477 |
|---|---|
| Provider Enumeration Date | 2007-05-21 |
| Last Updated Date | 2016-04-13 |
Provider Mailing Address Detail
| Address | Po Box 22040 |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543052040 |
| Phone Number | 9204457222 |
| Fax Number | 9204457289 |
Provider's Primary Taxonomy Detail
| Speciality | Art Therapist |
|---|---|
| Taxonomy | 221700000X |
| Licence No | 62-036 |
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Definition: (1) An individual who uses art to achieve the therapeutic goals of symptom relief, emotional integration, and recovery from or adjustment to illness or disability. (2) An art therapist uses a form of treatment that enables patients with mental or phy |
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What is the unique 10-digit identification code issued to Jody B Larson by the Centers for Medicare & Medicaid Services?
The Jody B Larson has been assigned the NPI (National Provider Identifier) 1750590477 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Jody B Larson located?
The Jody B Larson is located at Po Box 22040, Green Bay, WI 543052040.
What is Jody B Larson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jody B Larson's area of specialization is Art Therapist, and the corresponding taxonomy code that categorizes this field of practice is 221700000X.
On what date did the Jody B Larson receive the assignment of its 1750590477 from the Centers for Medicare & Medicaid Services?
The Jody B Larson was issued its 1750590477 by the Centers for Medicare & Medicaid Services on 2007-05-21.
As of what date were the details related to Jody B Larson most recently updated or revised?
The information pertaining to Jody B Larson, including its address, specialty, and other relevant details, was last updated or revised on 2016-04-13.