Individual
DR. STEVE MARK LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1507 W MAIN ST, GATESVILLE, TX 76528-1024
(254) 865-8251
Mailing address
1507 W MAIN ST, GATESVILLE, TX 76528-1024
(254) 865-8251
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36884
TX
103TC2200X
Clinical Child & Adolescent Psychologist
PY0466
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100503261
—
NV
01
—
36884
STATE LICENSING BOARD
TX
Enumeration date
03/18/2006
Last updated
01/15/2016
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