Individual
LARRY BRENT EUBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
301 ANDREWS AVE., FT. RUCKER, AL 36362
(334) 255-7523
Mailing address
301 ANDREWS AVE., FT. RUCKER, AL 36362
(334) 255-7523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3540C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3540C
LICENSE
AL
Enumeration date
11/06/2013
Last updated
02/21/2022
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