Individual
MS. VIVIENNE VIOLET CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
350 N MARKET ST, YOUTH SERVICES, WICHITA, KS 67202-2010
(316) 263-2769
(316) 425-6174
Mailing address
350 N MARKET ST, YOUTH SERVICES, WICHITA, KS 67202-2010
(316) 263-2769
(316) 425-6174
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7599
KS
Other
Enumeration date
06/10/2009
Last updated
09/13/2010
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