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1831100379
W. GORDON FEDIACZKO
SALEM, OH
NPI
1831100379
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OH I-0002866)
Enumeration Date
2006-08-10
Last Update Date
2007-07-08
Business Address
-- W. GORDON FEDIACZKO L.I.S.W.
12680 SALEM WARREN RD
SALEM, OH 44460-9668
Phone number: 330-337-6527
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Mailing Address
-- W. GORDON FEDIACZKO L.I.S.W.
815 E 5TH ST
SALEM, OH 44460-1742
Phone number: 330-332-0153
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