Individual
KARIANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1251 NE ELM ST, PRINEVILLE, OR 97754-1206
(541) 323-5330
(541) 447-6694
Mailing address
1251 NE ELM ST, PRINEVILLE, OR 97754-1206
(541) 323-5330
(541) 447-6694
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283234
—
OR
Enumeration date
09/22/2015
Last updated
09/22/2015
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