Individual
ANDREA DEJACIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSA, LSW
Contact information
Practice address
724 LAKEVIEW DR, CORTLAND, OH 44410-1621
(330) 883-1563
Mailing address
724 LAKEVIEW DR., CORTLAND, OH 44410
(330) 883-1563
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1000821
OH
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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