Individual
CHARLOTTE ALLEGRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 BURKE ST APT 151, SOUTH BOSTON, MA 02127-3328
(617) 534-9500
Mailing address
1010 MASSACHUSETTS AVE, BOSTON, MA 02118-2600
(617) 419-3408
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
218335
MA
Other
Enumeration date
06/18/2012
Last updated
09/26/2012
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