Individual
MR. CLARK E WOOLDRIDGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW ACP
Contact information
Practice address
1220 MITCHELL, CLOVIS, NM 88101
(806) 681-6745
(505) 742-3182
Mailing address
3519 TRIPP, AMARILLO, TX 79121
(806) 359-4127
(806) 359-4127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
05339
TX
1041C0700X
Clinical Social Worker
Primary
I2267
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97107
—
NM
Enumeration date
08/30/2006
Last updated
07/08/2007
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