Individual
CHARITY A DETRICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
715 S PLUM ST, MARYSVILLE, OH 43040
(937) 644-9192
(937) 644-3426
Mailing address
PO BOX 817, WEST LIBERTY, OH 43357-0817
(937) 644-9192
(937) 644-3426
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0008990
OH
Other
Enumeration date
01/30/2006
Last updated
07/08/2007
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