Individual
COLLEEN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
225 HOUSTON ST, SAINT CHARLES, MO 63301-1621
(309) 360-9066
Mailing address
225 HOUSTON ST, SAINT CHARLES, MO 63301-1621
(309) 360-9066
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2022015053
MO
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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