Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3533 | AZ |
Y | 103TC0700X | Clinical Psychologist | 3533 | AZ |
N | 102L00000X | Psychologist | 3533 | AZ |
N | 103T00000X | Psychologist | 3533 | AZ |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 3533 | AZ |
N | 103G00000X | Clinical Psychologist | 3533 | AZ |
N | 103TC0700X | Clinical Psychologist | 3533 | AZ |
N | 103TH0100X | Health Service | 3533 | AZ |
N | 103TR0400X | Rehabilitation Psychologist | 3533 | AZ |
NPI | 1578604187 |
---|---|
Provider Name | Dr. Larry D Messer JR. |
First Address | Mesa, AZ 85277-0291 |
Second Address | Scottsdale, AZ 85258-4509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 16/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P96086 | (02) | AZ |