Individual
MRS. TRACEY ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
775 DENT ROAD, ROANOKE, VA 24019-4116
(540) 265-4281
(540) 265-4287
Mailing address
3229 ELLSWORTH ST. N.E., ROANOKE, VA 24012-3618
(540) 366-4950
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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