Individual
MIRANDA LYNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
69 EAST HAWLEY RD, HAWLEY, MA 01339
(413) 475-4785
Mailing address
69 E HAWLEY RD, HAWLEY, MA 01339-9610
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
08/13/2018
Last updated
08/13/2018
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