Individual
MS. KATHRYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
6032 40TH AVE, KENOSHA, WI 53142-7018
(262) 287-1999
(262) 287-0884
Mailing address
6032 40TH AVE, KENOSHA, WI 53142-7018
(262) 287-1999
(262) 287-0884
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134688-121
WI
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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