Provider Demographics
NPI:1699137471
Name:LARNEY, NORVA LYNN
Entity type:Individual
Prefix:
First Name:NORVA
Middle Name:LYNN
Last Name:LARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10628 NE 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-5026
Mailing Address - Country:US
Mailing Address - Phone:405-757-8712
Mailing Address - Fax:
Practice Address - Street 1:10628 NE 59TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-5026
Practice Address - Country:US
Practice Address - Phone:405-757-8712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst