Individual
BECKY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
731 TILGHMAN DR, DUNN, NC 28334-5507
(910) 249-4219
Mailing address
731 TILGHMAN DR, DUNN, NC 28334-5507
(910) 249-4219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004606
NC
251S00000X
Community/Behavioral Health Agency
1041C0700
NC
Other
Enumeration date
04/17/2017
Last updated
04/18/2017
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