Individual
SHIRLEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P-LCSW
Contact information
Practice address
1313 FIRST ST W, AHOSKIE, NC 27910-8842
(252) 209-8932
(252) 209-8933
Mailing address
1313 FIRST ST W, AHOSKIE, NC 27910-8842
(252) 209-8932
(252) 209-8933
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P003721
NC
Other
Enumeration date
09/25/2008
Last updated
09/25/2008
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