Individual
MR. CRAIG RUSSELL LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1807 NORTHBRIDGE PL, DOWNERS GROVE, IL 60516-3186
(630) 969-1756
(312) 592-4958
Mailing address
1807 NORTHBRIDGE PL, DOWNERS GROVE, IL 60516-3186
(630) 969-1756
(312) 592-4958
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
11/11/2006
Last updated
07/08/2007
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