Individual
JENNIFER ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1123 CLAIREMONT AVE, DECATUR, GA 30030-1207
(404) 444-6621
(877) 853-5776
Mailing address
1123 CLAIREMONT AVE, DECATUR, GA 30030-1207
(404) 444-6621
(877) 853-5776
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW008887
GA
1041C0700X
Clinical Social Worker
Primary
CSW008185
GA
Other
Enumeration date
05/23/2019
Last updated
11/21/2022
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