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1194731091
DEREK R LARSON
LAYTON, UT
NPI
1194731091
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 4941733-3501)
Enumeration Date
2006-07-31
Last Update Date
2013-09-25
Business Address
-- DEREK R LARSON LCSW
2250 N 1700 W
LAYTON, UT 84041-1140
Phone number: 801-773-7060
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Mailing Address
-- DEREK R LARSON LCSW
PO BOX 460
BOUNTIFUL, UT 84011-0460
Phone number: 801-298-3446
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