NPI 1083872642

Russell Ellis Lark, PHD

Practitioner Counseling Psychologist West Des Moines, IA

Practice location

Address: 1200 Valley West Dr Suite 707, West Des Moines, IA 50266-1908
Phone: (515) 222-1999
Fax: (515) 224-3949

Registered specialties

Counseling Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC1900X Licence 001057 (IA)

Other Psychologist providers in Iowa →

Registry record

NPI: 1083872642
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 May 2008
Record last updated: 29 May 2008

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.