Doctor Name: | MR. LARRY H. CLONINGER |
NPI Number: | 1326158874 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C. |
License Number: | 000027 |
Business Practice Address: | 14312 Dillon Outer Rd Saint James, MO - 655598790 |
Business Phone Number: | 5735780198 |
Business Fax Number: | 5732650371 |
Mailing Address: | 14312 Dillon Outer Rd, SAINT JAMES |
State: | MO |
Postal Code: | 655598790 |
Phone Number: | 5735780198 |
Fax Number: | 5732650371 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 000027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |