KELLEY NICOLE LARSON

ROCKFORD, IL
NPI1023764263
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.026923)
Additional Taxonomies104100000X Social Worker
(Licence: IL  150105997)
Enumeration Date2022-02-25
Last Update Date2025-06-11
Business Address
Mrs. KELLEY NICOLE LARSON LSW
301 E STATE ST
ROCKFORD, IL 61104-1012
Phone number: 815-668-7810
Mailing Address
Mrs. KELLEY NICOLE LARSON LSW
PO BOX 746715
ATLANTA, GA 30374-6715
Phone number: 773-352-1515