Miranda Cathleen Larson, BCTMB, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

1539 Issued in ND

Practice address

112 University Dr N
Ste 316
Fargo, ND 58102-4661

Phone

(218) 289-0276

NPI assigned

Jun 24, 2010

Sex

Female

Sole proprietor

No

• Miranda Cathleen Hendrickson Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2017.

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1437460334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N",
            "address_2": "STE 316",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "218-289-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N",
            "address_2": "STE 316",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "218-289-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MIRANDA",
        "middle_name": "CATHLEEN",
        "credential": "BCTMB, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ND",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "HENDRICKSON",
            "middle_name": "CATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberlie Larson, RN, BSN
• Loni Larson, LICSW
• Mary F Larson, LRD, MPH
• Megan Elizabeth Larson, APRN, CNP
• Michael Larson
• Nicole Andrea Larson, MS, LPC, LPCC
• Robin S Larson, RN
• Sarah Mae Larson, PHARMD
• Sophia Larson
• Sydney Larson, LAPC

• All providers in Fargo, ND
• Massage Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.