Individual
CHANIYA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
3584 FAIRLANES AVE SW STE 2, GRANDVILLE, MI 49418-1583
(616) 797-2124
Mailing address
148 LAFAYETTE AVE NE UNIT 5, GRAND RAPIDS, MI 49503-5600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6852093714
MI
Other
Enumeration date
08/27/2024
Last updated
02/26/2026
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