NPI 1063139772

Craig M Larsen, CPRCCPRCS

Practitioner Peer Specialist Caldwell, ID

Practice location

Address: 304 W Logan St, Caldwell, ID 83605-4735
Phone: (208) 402-6782

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence 11926 (ID)

Other Peer Specialist providers in Idaho →

Registry record

NPI: 1063139772
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Oct 2022
Record last updated: 24 Oct 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.