Doctor Name: | WILLIAM RAYMOND LARRICK |
NPI Number: | 1447381041 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | 1422 |
Business Practice Address: | Us Hwy 491 North Shiprock, NM - 87420 |
Business Phone Number: | 5053687100 |
Business Fax Number: | |
Mailing Address: | Po Box 160, SHIPROCK |
State: | NM |
Postal Code: | 874200160 |
Phone Number: | 5053687100 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 09/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1422 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |