| Doctor Name: | LARRY DEVON GANTT |
| NPI Number: | 1437433067 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | |
| Business Practice Address: | 111 S Treaty Rd Miami, OK - 743545327 |
| Business Phone Number: | 9185401511 |
| Business Fax Number: | 9185427374 |
| Mailing Address: | 114 W Delware Ave, NOWATA |
| State: | OK |
| Postal Code: | 740482601 |
| Phone Number: | 9182731841 |
| Fax Number: | 9182731843 |
| NPI Enumeration Date: | 09/30/2011 |
| NPI Last Update Date: | 10/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |