Individual
TERRI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 E MATTHEWS AVE, JONESBORO, AR 72401-4347
(870) 972-1268
(870) 934-0847
Mailing address
2809 FOREST HOME RD, JONESBORO, AR 72401-5320
(866) 972-1268
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6664-M
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191510795
—
AR
Enumeration date
11/18/2008
Last updated
08/30/2021
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