Provider Demographics
NPI:1508001769
Name:LARSEN, MARGARET ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANN
Last Name:LARSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 W M 43 HWY
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-8378
Mailing Address - Country:US
Mailing Address - Phone:269-945-3888
Mailing Address - Fax:269-945-2112
Practice Address - Street 1:1761 W M 43 HWY
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-8378
Practice Address - Country:US
Practice Address - Phone:269-945-3888
Practice Address - Fax:269-945-2112
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000532231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist