Individual
COLETTE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISW-S
Contact information
Practice address
4633 AICHOLTZ RD., CINCINNATI, OH 45244-4524
(513) 752-1555
(513) 752-1555
Mailing address
4629 AICHOLTZ RD., CINCINNATI, OH 45244-1557
(513) 752-1555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31-0952668
—
OH
Enumeration date
09/26/2013
Last updated
03/17/2018
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