Travis Cody Larsen

NPI #1386119238 in Orem, Utah

Provider Information

NPI Number: 1386119238
Entity Type: Individual
Name: Travis Cody Larsen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Oct 8, 2018
Last Updated: Oct 8, 2018

Practice Location

Address: 360 S STATE ST STE 103
City: Orem
State: Utah
ZIP Code: 84058-5745
Phone: (801) 377-1117

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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