National Provider Identifier
Mark R. Larson, PH.D.
Mark R. Larson, PH.D. is listed in the NPPES registry with a primary specialty of Clinical Psychologist in Rochester, NY and a listed phone number of (585) 473-5810.
Profile Overview
- NPI
- 1124088208
- Provider Type
- Individual
- Primary Specialty
- Clinical Psychologist
- Enumeration Date
- March 24, 2006
- Last Updated
- July 08, 2007
Practice Location
- 130 Allens Creek RD
- Rochester, NY 14618-3305
Phone: (585) 473-5810
Specialties
- Clinical Psychologist (103TC0700X)
Full Record
- NPI
- 1124088208
- Entity Type
- Individual
- Last Name
- Larson
- First Name
- Mark
- Middle Name
- R.
- Credential
- PH.D.
- Mailing Street Address
- 130 Allens Creek RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14618-3305
- Mailing Country
- US
- Mailing Phone
- (585) 473-5810
- Mailing Fax
- (585) 473-5193
- Practice Street Address
- 130 Allens Creek RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14618-3305
- Practice Country
- US
- Practice Phone
- (585) 473-5810
- Practice Fax
- (585) 473-5193
- Enumeration Date
- March 24, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Psychologist (103TC0700X)
- Other Identifiers
- 106063FC (NY, Preferred Care), 7043329 (NY, Aetna), S13650-7W (NY, Worker'S Compensation)