Individual
DANIEL CLAUDE COLEGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
312 3RD ST, ELYRIA, OH 44035-5618
(440) 323-5707
Mailing address
951 VINEYARD DR APT 404, BROADVIEW HEIGHTS, OH 44147-3350
(440) 665-5260
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1600921
OH
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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