Individual
MR. A. BROOKS LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
133 N 100 W, MAYFIELD, UT 84643-0209
(209) 669-2880
(435) 528-5394
Mailing address
PO BOX 209, MAYFIELD, UT 84643-0209
(092) 669-2880
(354) 528-5394
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS12724
CA
Other
Enumeration date
01/10/2008
Last updated
11/10/2022
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