Individual
SAMUEL W LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2200 21ST AVE S STE 300, NASHVILLE, TN 37212-4929
(615) 933-3571
Mailing address
1819A SHACKLEFORD RD, NASHVILLE, TN 37215-3525
(773) 351-4913
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
3698
TN
Other
Enumeration date
09/09/2015
Last updated
02/11/2020
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