Individual
KRISTINA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
390 ERIE AVE, CONNERSVILLE, IN 47331-3177
(765) 377-1090
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34012855A
IN
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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