National Provider Identifier
Malissa Ann Larson
Malissa Ann Larson is listed in the NPPES registry with a primary specialty of Doula in Buffalo, NY and a listed phone number of (646) 823-5401.
Profile Overview
- NPI
- 1982175824
- Provider Type
- Individual
- Primary Specialty
- Doula
- Enumeration Date
- December 17, 2018
- Last Updated
- June 11, 2019
Practice Location
- 192 Richmond Ave
- Buffalo, NY 14222-2112
Phone: (646) 823-5401
Specialties
- Doula (374J00000X)
- Exercise & Sports Psychologist (103TE1100X)
Full Record
- NPI
- 1982175824
- Entity Type
- Individual
- Last Name
- Larson
- First Name
- Malissa
- Middle Name
- Ann
- Name Prefix
- Miss
- Mailing Street Address
- 192 Richmond Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14222-2112
- Mailing Country
- US
- Mailing Phone
- (646) 823-5401
- Practice Street Address
- 192 Richmond Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14222-2112
- Practice Country
- US
- Practice Phone
- (646) 823-5401
- Enumeration Date
- December 17, 2018
- Last Updated
- June 11, 2019
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193200000X Multi-Specialty Group
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Doula (374J00000X), Exercise & Sports Psychologist (103TE1100X)