Provider Information for 1508992785
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LARRY J ANDREWS PHD, LPC
Sex: Male
NPI: 1508992785
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1508992785 | ||||||||
| Enumeration Date | 2007-02-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 18 JOHN WAYNE LN POWELL, WY 82435-9469 United States Phone: 307-272-8880 | Fax: | ||||||||
| Primary Practice Address | 1102 BECK AVE CODY, WY 82414-3624 United States Phone: 307-587-8889 | Fax: | ||||||||
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