Most Relevant Information
Provider Data
| NPI Number: | 1003029968 |
| Provider Name: | JACQUELINE CARR LISW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | I8314 |
Most Important Dates
| Enumeration Date: | 05/08/2007 |
| Last Updated: | 03/16/2016 |
Provider Practice Location
511 PERRY ST
DEFIANCE
OH
435122123
Practice Location Phone/Fax
| Phone: | 4197829920 |
| Fax: | 4197842523 |
Provider Mailing Location
511 PERRY ST
DEFIANCE
OH
435122123
Provider Mailing Phone/Fax
| Phone: | 4197829920 |
| Fax: | 4197842523 |