Larissa Elise Irwin

NPI #1497367445 in Cheyenne, Wyoming

Provider Information

NPI Number: 1497367445
Entity Type: Individual
Name: Larissa Elise Irwin
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Aug 20, 2020
Last Updated: Aug 20, 2020

Practice Location

Address: 3120 OLD FAITHFUL RD STE 100
City: Cheyenne
State: Wyoming
ZIP Code: 82001-5890
Phone: (307) 221-2937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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