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Individual

PETER A CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
10 WATER ST STE 306, WATERVILLE, ME 04901-6566
(207) 861-6200
(207) 861-3470
Mailing address
10 WATER ST STE 306, WATERVILLE, ME 04901
(207) 861-6200
(207) 861-3470

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12415
ME

Other

Enumeration date
05/10/2010
Last updated
05/10/2010
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