Individual
BRENDA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
4641 FULTON DR NW, CANTON, OH 44718-2384
(330) 433-6075
Mailing address
2662 WINTERGREEN LN, RAVENNA, OH 44266-7836
(330) 357-6797
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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