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Individual

MR. LARRY TODD ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.C.

Contact information

Practice address
2725 N WESTWOOD BLVD, SUITE 5A, POPLAR BLUFF, MO 63901-2346
(573) 785-0333
(573) 785-0333
Mailing address
2725 N WESTWOOD BLVD, SUITE 5A, POPLAR BLUFF, MO 63901-2346
(573) 785-0333
(573) 785-0333

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002436
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000443672
ANTHEM BLUE CROSS BLUE SHIELD
MO
01
1053376467
UNITED HEALTHCARE
MO
05
1053376467
MO
Enumeration date
04/19/2006
Last updated
05/24/2011
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