Individual
AMANDA ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, QIDP
Contact information
Practice address
3310 EAGLE PARK DR NE, GRAND RAPIDS, MI 49525-4574
(616) 336-3909
Mailing address
3310 EAGLE PARK DR NE, GRAND RAPIDS, MI 49525-4574
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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