Individual
CARY ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2218 JACKSON AVE NW, OLYMPIA, WA 98502-4535
(270) 305-9625
Mailing address
2218 JACKSON AVE NW, OLYMPIA, WA 98502-4535
(270) 305-9625
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC60303688
WA
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
SA60303385
WA
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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