Individual
MR. RONALD WAYNE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRC
Contact information
Practice address
8609 LYNDALE AVE S, 101K, BLOOMINGTON, MN 55420-2754
(952) 888-2424
(952) 888-6729
Mailing address
8609 LYNDALE AVE S, 101K, BLOOMINGTON, MN 55420-2754
(952) 888-2424
(952) 888-6729
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
QRC#290
MN
Other
Enumeration date
02/22/2013
Last updated
02/22/2013
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