Individual
BRENDA FLYNN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601N STATE ST, UKIAH, CA 95482-4026
(707) 391-3153
Mailing address
214 SCOTT ST, UKIAH, CA 95482-4318
(707) 391-3153
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS23281
CA
Other
Enumeration date
10/05/2012
Last updated
09/09/2015
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