Individual
NICOLE ELIZABETH LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
101 5TH ST E STE 207, NORTHFIELD, MN 55057-2076
(507) 301-6741
(507) 517-3492
Mailing address
101 5TH ST E STE 207, NORTHFIELD, MN 55057-2076
(507) 301-6741
(507) 517-3492
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21088
MN
Other
Enumeration date
10/24/2012
Last updated
01/03/2022
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