| Doctor Name: | DAVID LARSON |
| NPI Number: | 1316048770 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P. |
| License Number: | LP0618 |
| Business Practice Address: | 244 W Clark St Albert Lea, MN - 560072548 |
| Business Phone Number: | 5073737913 |
| Business Fax Number: | 5073737913 |
| Mailing Address: | 244 W Clark St, ALBERT LEA |
| State: | MN |
| Postal Code: | 560072548 |
| Phone Number: | 5073737913 |
| Fax Number: | 5073737913 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 04/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | LP0618 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |