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Individual

ELISA M CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
272 BROAD ST, RED BANK, NJ 07701-2044
(732) 747-7665
Mailing address
66 MIDDLETOWN RD, HOLMDEL, NJ 07733-2206
(609) 661-3660

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05942500
NJ

Other

Enumeration date
07/22/2022
Last updated
07/22/2022
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