Individual
LARRY CROOM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5836 S PECOS RD, LAS VEGAS, NV 89120-3418
(800) 829-4933
Mailing address
5836 S PECOS RD, LAS VEGAS, NV 89120-3418
(800) 829-4933
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
814779557
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814779557
—
NV
Enumeration date
01/16/2017
Last updated
01/16/2017
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