Provider Demographics
NPI:1154020741
Name:PLAYER, LARRY D (PMFT)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:D
Last Name:PLAYER
Suffix:
Gender:M
Credentials:PMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 THOMES AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3545
Mailing Address - Country:US
Mailing Address - Phone:307-369-4710
Mailing Address - Fax:307-222-0279
Practice Address - Street 1:1920 THOMES AVE STE 310
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3545
Practice Address - Country:US
Practice Address - Phone:307-369-4710
Practice Address - Fax:307-222-0279
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY305106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist