MEDICARE: MADELINE VIANE LARKIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9511-C	AR

General Provider Information

NPI Number	:	1548095094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE VIANE LARKIN

Provider Business Mailing Address
First Line	:	159 JOHN QUICK RD
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-9762
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	159 JOHN QUICK RD
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-9762
Country	:	US
Telephone Number	:	501-672-4981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	09/04/2024

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