Individual
DR. JOHN A. LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5350 W 94TH TER, SUITE 204, PRAIRIE VILLAGE, KS 66207-2504
(913) 322-4235
(913) 322-4236
Mailing address
5350 W 94TH TER, SUITE 204, PRAIRIE VILLAGE, KS 66207-2504
(913) 322-4235
(913) 322-4236
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1300
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09792026
BCBS
MO
05
—
493440309
—
MO
Enumeration date
08/31/2006
Last updated
04/15/2011
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