Individual
DIANE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
1115 WESTPORT DR STE D2, MANHATTAN, KS 66502-2871
(785) 560-3101
Mailing address
1115 WESTPORT DR STE D2, MANHATTAN, KS 66502-2871
(785) 560-3101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW2422
KS
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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