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General NPI Number Information
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NPI Number | 1477481877
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Entity Type | Individual
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Provider Name | KATHLEEN NOELLE LARSON MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 100 E EUCLID AVE STE 29
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City | DES MOINES
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State | IA
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Zip | 50313-4564
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Country | US
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Telephone | 515-207-5251
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Fax |
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Provider Business Mailing Address
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Address Line | 1319 SE DELAWARE AVE APT 4
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City | ANKENY
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State | IA
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Zip | 50021-4487
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Country | US
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Telephone | 515-207-5251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 118258
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0699
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License Number State | NE
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