Individual
MRS. LEIGH ANNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
124 N 4TH AVE, DECATUR, GA 30030-4204
(404) 281-3855
Mailing address
124 N 4TH AVE, DECATUR, GA 30030-4204
(404) 281-3855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
44SC05317700
NJ
101Y00000X
Counselor
CSW003971
GA
104100000X
Social Worker
44SL05284800
NJ
Other
Enumeration date
10/16/2006
Last updated
11/09/2021
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