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Individual
MR. LARRY KEVIN HAMBERGER
Active
Individual
MR. LARRY KEVIN HAMBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1004
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000119L
HUMANA
—
05
—
1780635524
—
WI
Enumeration date
05/15/2006
Last updated
01/24/2013
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