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1851319073
LARRY DEAN WEIGHT
ANOKA, MN
NPI
1851319073
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MN LICSW 4195)
Enumeration Date
2006-07-17
Last Update Date
2007-07-08
Business Address
Mr. LARRY DEAN WEIGHT LICSW
22426 SAINT FRANCIS BLVD
ANOKA, MN 55303-9670
Phone number: 763-753-7310
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Mailing Address
Mr. LARRY DEAN WEIGHT LICSW
22426 SAINT FRANCIS BLVD
ANOKA, MN 55303-9670
Phone number: 763-753-7310
Copy
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