Organization
GREGORY D. CLARK, MSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY DARWIN CLARK MSW (CLINICAL SOCIAL WORKER)
(701) 799-8785
Entity
Organization
Contact information
Practice address
118 BROADWAY N, SUITE 810, FARGO, ND 58102-4949
(701) 799-8785
(701) 205-4930
Mailing address
118 BROADWAY N, SUITE 810, FARGO, ND 58102-4949
(701) 799-8785
(701) 205-4930
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2973
ND
Other
Enumeration date
06/08/2015
Last updated
06/01/2016
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