Tracy Larson, MA

NPI #1972804052 in Mchenry, Illinois

Provider Information

NPI Number: 1972804052
Entity Type: Individual
Name: Tracy Larson, MA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: MA
Enumeration Date: Nov 5, 2010
Last Updated: Nov 5, 2010

Practice Location

Address: 4100 VETERANS PKWY
City: Mchenry
State: Illinois
ZIP Code: 60050-8350
Phone: (815) 385-6400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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