Individual
MRS. COLEEN D. LARRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICDC, LPN
Contact information
Practice address
1655 HOLLAND RD STE F, MAUMEE, OH 43537-1656
(866) 934-7450
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162003
OH
164W00000X
Licensed Practical Nurse
LPN.113413.MEDS-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2415738
—
OH
Enumeration date
03/12/2007
Last updated
08/22/2024
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