Individual
KEVEISHA ROBINSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 DUDLEY STREET, ROXBURY, MA 02119-2772
(617) 708-6174
Mailing address
102 1/2 GEORGE ST APT 3, ROXBURY, MA 02119-2772
(617) 708-6174
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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