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Diane Mary Larson
Mental Health Counselor in Wayzata, Minnesota
NPI 1649038506

Diane Mary Larson is a Mental Health Counselor based in Wayzata, MN and is specialized in Mental Health. Diane Mary Larson practices in Wayzata, MN. The NPI Number for Diane Mary Larson is 1649038506 and holds a License No. 02877 (Minnesota).

The current practice location address for Diane Mary Larson is 3701 Shoreline Dr Ste 102, Wayzata, MN and can be reached out via phone at 952-314-7533.

Location: 3701 Shoreline Dr Ste 102, Wayzata, MN, 55391-9591
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649038506
Provider Name
Diane Mary Larson
Credential
Provider Entity Type
Individual
Gender
Female
Address
3701 Shoreline Dr Ste 102, Wayzata, MN, 55391-9591
Phone Number
952-314-7533
Fax Number
Provider Enumeration Date
03/06/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
3701 Shoreline Dr Ste 102
City
Wayzata
State
Minnesota
Zip
55391-9591
Phone Number
952-314-7533
Fax Number
person
Provider Business Mailing Address Details
Address
3701 Shoreline Dr Ste 102
City
Wayzata
State
Minnesota
Zip
55391-9591
Phone Number
952-314-7533
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
02877 (Minnesota)
Definition
Definition to come...
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