Individual
JAMIE DECLERCQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-SUPV
Contact information
Practice address
924 N CABLE RD, LIMA, OH 45805-1704
(419) 969-3125
Mailing address
1100 SHAWNEE RD, LIMA, OH 45805-3583
(419) 999-3607
(419) 999-6284
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0031486-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251480
—
OH
Enumeration date
05/11/2011
Last updated
03/17/2024
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