Individual
DAVID LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.
Contact information
Practice address
244 W CLARK ST, ALBERT LEA, MN 56007-2548
(507) 373-7913
(507) 373-7913
Mailing address
244 W CLARK ST, ALBERT LEA, MN 56007-2548
(507) 373-7913
(507) 373-7913
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
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