Southard, Larry E

Southard, Larry E is an individual health care provider with primary practice located at 1255 E Highland Ave Ste 105, San Bernardino CA 92404. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Southard, Larry E can be contacted via phone (909) 881-5250.

Contact Information

Primary practice address
1255 E Highland Ave Ste 105 San Bernardino CA 92404
Phone: (909) 881-5250
Fax: (909) 337-2724
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFC18620 California

Profile Details

NPI number 1356304380
LBN Legal business name Southard, Larry E
Credentials MA MFT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356304380 NPPES
Other 061147 HEALTHNET
Other 065571 HEALTHNET
Other 186380 HEALTHNET
Other 33B61D HEALTHNET
Other 5362524 HEALTHNET
Other 019346 HEALTHNET
Other 56862099802 HEALTHNET
Other 3112 HEALTHNET
Other 386213 HEALTHNET
Other 6270815 HEALTHNET
Other 208994 HEALTHNET
Other MFT18620 HEALTHNET

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