Individual
CLIFFORD LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SWT
Contact information
Practice address
2140 E ELLSWORTH RD, ANN ARBOR, MI 48108-2552
(734) 222-3586
(734) 222-3461
Mailing address
555 TOWNER ST, PO BOX 915, YPSILANTI, MI 48198-5752
(734) 544-3000
(734) 544-6732
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6803081113
MI
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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