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General NPI Number Information
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NPI Number | 1740226851
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Entity Type | Individual
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Provider Name | KAREN T LARSON LP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 13045 FALCON DR STE 100
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City | BAXTER
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State | MN
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Zip | 56425-4201
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Country | US
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Telephone | 218-282-4746
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Fax | 218-829-7649
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Provider Business Mailing Address
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Address Line | 1900 SILVER LAKE RD NW
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-1786
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Country | US
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Telephone | 612-464-6671
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Fax | 651-628-0411
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | LP0943
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP0943
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP0943
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | LP0943
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License Number State | MN
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