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Individual

MR. CHARLES WHITMAN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSSS

Contact information

Practice address
45 BARTLETT CRESCENT, BROOKLINE, MA 02446
(617) 566-3105
Mailing address
45 BARTLETT CRESCENT, BROOKLINE, MA 02446
(617) 566-3105

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
100307
MA
1041C0700X
Clinical Social Worker
15W00180
RI

Other

Enumeration date
02/05/2007
Last updated
07/08/2007
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