Individual
MARY CATHERINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BSL, BSC, MT
Contact information
Practice address
62 PLAZA LN, WELLSBORO, PA 16901-1766
(570) 724-7142
(570) 724-6771
Mailing address
1 W MAIN ST, FLEETWOOD, PA 19522-1323
(610) 944-0445
(610) 944-8834
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
BH003138
PA
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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