Individual
VANESSA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
76605 GALLATIN RD, GALLATIN GATEWAY, MT 59730-8711
(406) 498-3235
Mailing address
PO BOX 102, GALLATIN GATEWAY, MT 59730-0102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24163
MT
Other
Enumeration date
01/01/2018
Last updated
01/01/2018
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