Individual
KERI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
6165 NW 86TH ST STE 200, JOHNSTON, IA 50131-2270
(515) 316-9720
Mailing address
6165 NW 86TH ST, JOHNSTON, IA 50131-2270
(515) 316-9720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05867
IA
Other
Enumeration date
10/17/2006
Last updated
07/23/2020
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