Individual
ANGELICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4155 E HARRY ST, WICHITA, KS 67218-3725
(785) 825-0541
Mailing address
110 W OTIS AVE, SALINA, KS 67401-8713
(785) 825-0541
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12255
KS
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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