Individual
MR. DOUGLAS JAMES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
BROCKTON VA MEDICAL CENTER, 940 BELMONT ST., BROCKTON, MA 02301
(774) 826-2340
Mailing address
1 MEETING HOUSE CIR, EAST SANDWICH, MA 02537-1513
(508) 888-7369
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106610
MA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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