Individual
DONIQUA MONAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
943 W ANDREWS AVE STE H, HENDERSON, NC 27536-2562
(252) 433-0061
(252) 433-0065
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P015494
NC
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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