Individual
MS. ANTONIA MAUREEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105
(413) 732-7419
Mailing address
305 OLD SPRINGFIELD RD, BELCHERTOWN, MA 01007-9694
(413) 695-9635
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
211024
MA
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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