Individual
JODIE M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3895 UPHAM ST STE 100, WHEAT RIDGE, CO 80033-4651
(303) 500-5055
Mailing address
6782 E BRIARWOOD DR, CENTENNIAL, CO 80112-1156
(602) 819-1842
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
886707529
CO
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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