Melissa Larson
Social Worker, Clinical in Somonauk, IL. Individual provider (NPI-1).
NPI number1699392001
StatusActive
Last updated in NPPESJul 1, 2020
Details
- NPI
- 1699392001
- Entity type
- Individual (NPI-1)
- Name
- Melissa Larson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 1, 2020
- Certification date
- Jul 1, 2020
- Last updated
- Jul 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149022152 | IL | Yes |
Practice location
400 E North StSomonauk, IL 60552-3162
Phone 815-579-4581
Mailing address
400 E North StSomonauk, IL 60552-3162
Phone 815-579-4581
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