Most Relevant Information
Provider Data
| NPI Number: | 1003454851 |
| Provider Name: | LARISSA PERRY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/11/2019 |
| Last Updated: | 10/15/2021 |
Provider Practice Location
901 O ST
SUITE C
ARCATA
CA
955215789
Practice Location Phone/Fax
| Phone: | 3039898171 |
| Fax: |
Provider Mailing Location
901 O ST
SUITE C
ARCATA
CA
955215789
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |