Individual
JAIME LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 WAYNE AVE, INDIANA, PA 15701-3514
(724) 464-2273
Mailing address
429 MANOR DR, EBENSBURG, PA 15931-4917
(814) 472-6060
(814) 472-1293
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/19/2019
Last updated
10/19/2019
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