Individual
LARRY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
216 E LUVERNE ST, LUVERNE, MN 56156-1610
(507) 283-9511
(507) 283-9514
Mailing address
216 E LUVERNE ST, PO BOX 686, LUVERNE, MN 56156-1610
(507) 283-9511
(507) 283-9514
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1054
MN
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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