NPI 1063055192

Jerome Allen Larson, PSS

Practitioner Peer Specialist Milwaukee, WI

Practice location

Address: 3090 N 53rd St, Milwaukee, WI 53210-1617
Phone: (414) 254-4291

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1063055192
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Oct 2019
Record last updated: 22 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.