Provider Demographics
NPI:1871231928
Name:SHOW, LARISSA
Entity Type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:SHOW
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 1:1653 STATE ROUTE 56
Mailing Address - Street 2:
Mailing Address - City:SPRING CHURCH
Mailing Address - State:PA
Mailing Address - Zip Code:15686-9728
Mailing Address - Country:US
Mailing Address - Phone:724-422-6343
Mailing Address - Fax:
Practice Address - Street 1:9800B MCKNIGHT RD STE 150
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6014
Practice Address - Country:US
Practice Address - Phone:412-364-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist