Individual
JOHN D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW-C
Contact information
Practice address
10905 FORT WASHINGTON RD, FORT WASHINGTON, MD 20744-5843
(301) 292-3994
(301) 292-4928
Mailing address
3604 WABASH AVE, BALTIMORE, MD 21215-7436
(410) 367-8943
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
04054
MD
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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