Individual provider · Type 1 NPI

Madeline Grace Larson

Addiction (Substance Use Disorder) Counselor · Conway, SC

NPI number 1437859675 Active

Practice location

2404 Wise Rd
Conway, SC 29526-5521

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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About NPI 1437859675

Madeline Grace Larson's National Provider Identifier is 1437859675, issued on Mar 7, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Conway, SC. The record was last updated on Mar 7, 2023.