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Provider Information for 1821435702


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Mrs. SARAH HILLARY LARSEN M.A.C.


Other Names:  
Former Name: 
Miss SARAH LARSEN ASTRONES

Sex: Female

NPI: 1821435702
Last Updated: 2024-11-25
Certification Date: 2024-11-25

Details

NameValue
NPI1821435702
Enumeration Date2013-05-31
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1811 W 2ND ST
STE 475
GRAND ISLAND, NE 68803-5413
United States

Phone: 308-850-3509 | Fax:308-381-5698
 
Primary Practice Address 428 MONTEMAR AVE APT D
CATONSVILLE, MD 21228-5297
United States

Phone: 308-850-3509 | Fax:308-381-5698
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthNE9960