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1134470545
LISA MARY DECLARK
PERRYSBURG, OH
NPI
1134470545
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OH E.1100125)
Enumeration Date
2012-09-25
Last Update Date
2016-07-08
Business Address
-- LISA MARY DECLARK
119 W 2ND ST
PERRYSBURG, OH 43551-1402
Phone number: 419-376-6059
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Mailing Address
-- LISA MARY DECLARK
119 W 2ND ST
PERRYSBURG, OH 43551-1402
Phone number: 419-376-6059
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