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Ms. Mary St. John Larson, LMT,CMTPT
Specialist in Orange Park, Florida
NPI 1043346687

Mary St. John Larson is a Specialist based in Orange Park, FL. Mary St. John Larson practices in Orange Park, FL and has the professional credentials of LMT,CMTPT. The NPI Number for Mary St. John Larson is 1043346687 and holds a License No. MA 39861 (Florida).

The current practice location address for Mary St. John Larson is 2301 Park Ave, Orange Park, FL and can be reached out via phone at 904-215-9923.

Location: 2301 Park Ave, Orange Park, FL, 32073-5565
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043346687
Provider Name
Mary St. John Larson
Credential
LMT,CMTPT
Provider Entity Type
Individual
Gender
Female
Address
2301 Park Ave, Orange Park, FL, 32073-5565
Phone Number
904-215-9923
Fax Number
Provider Enumeration Date
02/26/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C4073 01 FL BCBSF
institution
Provider Business Practice Location Address Details
Address
2301 Park Ave
City
Orange Park
State
Florida
Zip
32073-5565
Phone Number
904-215-9923
Fax Number
person
Provider Business Mailing Address Details
Address
2301 Park Ave
City
Orange Park
State
Florida
Zip
32073-5565
Phone Number
904-215-9923
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MA 39861 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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