Individual
JAIME N FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
850 W ELM ST, WAUSEON, OH 43567-1189
(567) 343-6068
(413) 254-6065
Mailing address
PO BOX 293, WAUSEON, OH 43567-0293
(567) 343-6068
(413) 254-6065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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