Individual
KRYSTAL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
917 PARKER RD, ELLIJAY, GA 30536-7957
(678) 357-7224
Mailing address
917 PARKER RD, ELLIJAY, GA 30536-7957
(678) 357-7224
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW008048
GA
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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