Doctor Name: | MR. PETER S. LARKIN |
NPI Number: | 1063680080 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | SS 410 |
Business Practice Address: | 126 Colechester Ln Palm Coast, FL - 321379000 |
Business Phone Number: | 3864454236 |
Business Fax Number: | |
Mailing Address: | 126 Colechester Ln, PALM COAST |
State: | FL |
Postal Code: | 321379000 |
Phone Number: | 3864454236 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2008 |
NPI Last Update Date: | 02/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | SS 410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |