Individual
LARRY SILVERNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1403 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-6398
(651) 633-4532
Mailing address
1420 WATERFORD DR, MINNEAPOLIS, MN 55422-4275
(763) 588-7590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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