Individual
AMANDA LYNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW-C
Contact information
Practice address
16701 MELFORD BLVD STE 400, BOWIE, MD 20715-4411
(415) 424-4266
(415) 520-6633
Mailing address
8300 ESTERS BLVD STE 900, IRVING, TX 75063-2233
(415) 424-4266
(415) 520-6633
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21240
MD
Other
Enumeration date
05/06/2022
Last updated
05/14/2024
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