Individual
FAITH CLARK
Active
Individual
FAITH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303205
MN
1041C0700X
Clinical Social Worker
Primary
18726
MN
Other
Enumeration date
02/26/2019
Last updated
01/31/2022
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