Individual
DEREK R LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
75TH MEDICAL GROUP, 7321 BALMER STREET BUILDING 570, HILL AFB, UT 84056
(801) 777-7909
Mailing address
75TH MEDICAL GROUP, 7321 BALMER STREET BUILDING 570, HILL AFB, UT 84056
(801) 777-7909
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4941733-3501
UT
Other
Enumeration date
07/31/2006
Last updated
12/03/2024
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