| Doctor Name: | LARRY KIRK HAZEN |
| NPI Number: | 1033121520 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCSW-26947 |
| Business Practice Address: | 260 2nd Ave E Twin Falls, ID - 833016242 |
| Business Phone Number: | 2087320947 |
| Business Fax Number: | |
| Mailing Address: | 1887 Riverwood Rd, TWIN FALLS |
| State: | ID |
| Postal Code: | 833013084 |
| Phone Number: | 2087333730 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW-26947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |