National Provider Identifier

Tracy Lorraine Larson, PSY.D.

Tracy Lorraine Larson, PSY.D. is listed in the NPPES registry with a primary specialty of Psychologist in Newark, NY and a listed phone number of (315) 331-6030.

NPI 1689630675Newark, NYPsychologist

Profile Overview

NPI
1689630675
Provider Type
Individual
Primary Specialty
Psychologist
Enumeration Date
April 26, 2006
Last Updated
July 08, 2007

Practice Location

  • 211 West Ave
  • Newark, NY 14513-1336

Phone: (315) 331-6030

Specialties

  • Psychologist (103T00000X)
Full Record
NPI
1689630675
Entity Type
Individual
Last Name
Larson
First Name
Tracy
Middle Name
Lorraine
Name Prefix
Dr.
Credential
PSY.D.
Mailing Street Address
211 West Ave
Mailing City
Newark
Mailing State
NY
Mailing ZIP Code
14513-1336
Mailing Country
US
Mailing Phone
(315) 331-6030
Mailing Fax
(315) 331-9119
Practice Street Address
211 West Ave
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513-1336
Practice Country
US
Practice Phone
(315) 331-6030
Practice Fax
(315) 331-9119
Enumeration Date
April 26, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
X
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Psychologist (103T00000X)