Individual
DR. LARRY L LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
28 ANDOVER STREET, ANDOVER, MA 01810
(978) 475-6622
(978) 475-8436
Mailing address
28 ANDOVER STREET, ANDOVER, MA 01810
(978) 475-6622
(978) 475-8436
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
575
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501735
—
MA
Enumeration date
08/30/2006
Last updated
12/07/2010
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