Individual
AMBER TERESA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3035 E MOUND RD, DECATUR, IL 62526-9650
(217) 554-3000
(217) 875-2689
Mailing address
3035 E MOUND RD, DECATUR, IL 62526-9650
(217) 554-3000
(217) 875-2689
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149014123
IL
Other
Enumeration date
12/21/2009
Last updated
04/03/2013
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