Individual
TRACY ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 927-7628
(731) 927-7642
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 512-1571
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
721
TN
Other
Enumeration date
09/14/2010
Last updated
09/16/2010
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