Provider Demographics
NPI:1306022009
Name:LARSEN, CHRISTINA CORINNE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:CORINNE
Last Name:LARSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S BOSTON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-1208
Mailing Address - Country:US
Mailing Address - Phone:918-382-7300
Mailing Address - Fax:
Practice Address - Street 1:616 S BOSTON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-1208
Practice Address - Country:US
Practice Address - Phone:918-382-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor