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Individual

DR. LARRY CANTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
190 LIME QUARRY RD., STE 116, MADISON, AL 35758
(256) 461-8896
(256) 461-8897
Mailing address
190 LIME QUARRY RD, STE 116, MADISON, AL 35758
(256) 461-8896
(256) 461-8897

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
851
AL
101YP2500X
Professional Counselor
Primary
851
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510-99661
FEDERAL BLUE CROSS NO
AL
Enumeration date
10/06/2006
Last updated
05/02/2013
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