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Organization
MAKING CONNECTIONS
Active
Organization
MAKING CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISSA MARIE DIDRIKSEN LCSW (OWNER)
(262) 208-0078
Entity
Organization
Contact information
Practice address
9716 US HIGHWAY 12, RICHMOND, IL 60071-9253
(262) 208-0078
Mailing address
W1037 ARALIA RD, GENOA CITY, WI 53128-1574
(262) 208-0078
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/06/2007
Last updated
10/28/2019
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