| Doctor Name: | MR. KENT GARTH LARSON |
| NPI Number: | 1073656906 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.S.W. |
| License Number: | 279663-3501 |
| Business Practice Address: | 3578 W 4850 S Taylorsville, UT - 841182836 |
| Business Phone Number: | 8019674560 |
| Business Fax Number: | 8019679638 |
| Mailing Address: | 3578 W 4850 S, TAYLORSVILLE |
| State: | UT |
| Postal Code: | 841182836 |
| Phone Number: | 8019674560 |
| Fax Number: | 8019679638 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 279663-3501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |