Individual
ANNETTE M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8400
(877) 601-5854
Mailing address
124 ELTON HILLS LN NW, ROCHESTER, MN 55901-3577
(507) 282-1009
(507) 282-0932
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
112234
TX
1041C0700X
Clinical Social Worker
11843
MN
Other
Enumeration date
07/31/2015
Last updated
05/06/2024
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