IndividualActive
Latasha Larson, OT
NPI 1346911351 · Environmental Modification Occupational Therapist · Corcoran, MN
Provider details
- NPI number
- 1346911351
- Entity type
- Individual
- Primary specialty
- Environmental Modification Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OT
- Sex
- Female
- Sole proprietor
- No
- License
- 103693 (MN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
19120 Mystique Dr
Corcoran, MN 55340-9586
Phone: (320) 293-3205
Approximate (ZIP-level) locationGet directions
Mailing address
19120 Mystique Dr
Corcoran, MN 55340-9586
Registry dates
- Enumerated
- 2021-09-21
- Last updated
- 2023-01-17
- Certified
- 2023-01-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.