Dr. John Larson, Ph.D.
Psychologist, School in Spearfish, SD. Individual provider (NPI-1).
NPI number1982152609
StatusActive
Last updated in NPPESSep 12, 2016
Details
- NPI
- 1982152609
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Larson
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2016
- Last updated
- Sep 12, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | 73165-2 | SD | Yes |
Practice location
525 E Illinois StSpearfish, SD 57783-2521
Phone 605-717-1219
Mailing address
525 E Illinois StSpearfish, SD 57783-2521
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