Individual
DR. JOHN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
525 E ILLINOIS ST, SPEARFISH, SD 57783-2521
(605) 717-1219
Mailing address
525 E ILLINOIS ST, SPEARFISH, SD 57783-2521
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
73165-2
SD
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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