Healthcare Provider Details

I. General information

NPI: 1083679369
Provider Name (Legal Business Name): LAWRENCE JOSEPH LARDIERI PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TUNNEL RD DEPARTMENT OF VETERAN AFFAIRS
ASHEVILLE NC
28805-2043
US

IV. Provider business mailing address

24 W EUCLID PKWY
ASHEVILLE NC
28804-1416
US

V. Phone/Fax

Practice location:
  • Phone: 800-932-6408
  • Fax: 828-299-5992
Mailing address:
  • Phone: 828-230-6783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3228
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: