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Individual

MS. MONICA MARY CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW LISW LMFT

Contact information

Practice address
2102 EAST 38TH ST, DAVENPORT, IA 52807
(563) 359-4049
(563) 359-4069
Mailing address
2102 EAST 38TH ST, DAVENPORT, IA 52807
(563) 359-4049
(563) 359-4069

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0821
IA
106H00000X
Marriage & Family Therapist
16
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1108750000
IA
Enumeration date
02/17/2006
Last updated
09/26/2013
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