Individual
MR. STEPHEN ARTHUR DECLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
700 VILLA ST, RACINE, WI 53403-1144
(262) 902-5602
(262) 619-3263
Mailing address
700 VILLA ST, RACINE, WI 53403-1144
(262) 902-5602
(262) 619-3263
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6701-123
WI
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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