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Individual
MR. LARRY LEE BARDELL
Active
Individual
MR. LARRY LEE BARDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MN, PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
077038453N6 PMHNP-PP
OR
Other
Enumeration date
08/07/2006
Last updated
03/07/2023
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