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1083872642
RUSSELL ELLIS LARK
WEST DES MOINES, IA
NPI
1083872642
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC1900X Psychologist, Counseling
(Licence: IA 001057)
Enumeration Date
2008-05-29
Last Update Date
2008-05-29
Business Address
Dr. RUSSELL ELLIS LARK Ph.D.
1200 VALLEY WEST DR SUITE 707
WEST DES MOINES, IA 50266-1908
Phone number: 515-222-1999
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Mailing Address
Dr. RUSSELL ELLIS LARK Ph.D.
1200 VALLEY WEST DR SUITE 707
WEST DES MOINES, IA 50266-1908
Phone number:
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