Organization
CLARK-DOOLITTLE ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM CLARK LICSW (OWNER)
(617) 547-7292
Entity
Organization
Contact information
Practice address
71 WALKER ST, CAMBRIDGE, MA 02138-2414
(617) 547-7292
Mailing address
71 WALKER ST, CAMBRIDGE, MA 02138-2414
(617) 547-7292
(802) 763-2182
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0890000559
VT
1041C0700X
Clinical Social Worker
Primary
101057
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OUN2222
—
VT
Enumeration date
09/13/2005
Last updated
08/22/2020
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