Individual
DR. LYNN DALE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2980 S RAINBOW BLVD, SUITE 200A, LAS VEGAS, NV 89146-6531
(702) 315-5670
(702) 315-5672
Mailing address
2980 S RAINBOW BLVD, SUITE 200A, LAS VEGAS, NV 89146-6531
(702) 315-5670
(702) 315-5672
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY137
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1911456000
OWCP DOL
—
Enumeration date
11/02/2012
Last updated
11/02/2012
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