Individual
KEITRAYANA YVETTE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SWT
Contact information
Practice address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(419) 528-5993
(567) 560-5483
Mailing address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(419) 528-5993
(567) 560-5483
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
S.2604919-TRNE
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/05/2018
Last updated
03/05/2026
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