Individual
BRIDGET SHOUSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
6271 HORNER SIDING RD, OXFORD, NC 27565
(919) 603-4408
Mailing address
6271 HORNER SIDING RD, OXFORD, NC 27565-7563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P012712
NC
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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