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Individual

MR. LARRY DEAN WEIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
22426 SAINT FRANCIS BLVD, ANOKA, MN 55303-9670
(763) 753-7310
(763) 753-6529
Mailing address
22426 SAINT FRANCIS BLVD, ANOKA, MN 55303-9670
(763) 753-7310
(763) 753-6529

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW 4195
MN

Other

Enumeration date
07/17/2006
Last updated
07/08/2007
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