Individual
MRS. CATHLEEN ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1706 N BRADY, SUITE 204, DAVENPORT, IA 52803
(563) 650-1414
Mailing address
PO BOX 16, LECLAIRE, IA 52753
(563) 289-4748
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
03801
IA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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