Individual
DR. MARK DOUGLAS LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.MIN., L.P.C.
Contact information
Practice address
605 EAST BOULEVARD, METHODIST COUNSELING & CONSULTATION SERVICES, CHARLOTTE, NC 28203-5111
(704) 375-5354
Mailing address
2935 FOREST PARK DR, CHARLOTTE, NC 28209-1401
(704) 334-7543
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2189
NC
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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