Individual
JAEDAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
250 MONROE AVE NW STE 400, GRAND RAPIDS, MI 49503-2293
(616) 329-3511
Mailing address
250 MONROE AVE NW STE 400, GRAND RAPIDS, MI 49503-2293
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801104040
MI
104100000X
Social Worker
6851104040
MI
Other
Enumeration date
04/03/2019
Last updated
01/13/2025
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