Individual
DAVID LARSON
Active
Individual
DAVID LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP0618
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103748000
—
MN
01
—
115228
UCARE AND SCHA
MN
01
—
30235LA
BCBS
MN
01
—
411805759
BHP
MN
01
—
99099
PREFERRED ONE
MN
Enumeration date
09/26/2006
Last updated
04/19/2010
Update your record
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