Individual
SHAWANDA B CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, M.ED
Contact information
Practice address
120 MUMSFORD CT, UNION CITY, GA 30291-3471
(470) 257-1371
Mailing address
120 MUMSFORD CT, UNION CITY, GA 30291-3471
(470) 257-1371
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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