Individual
MICHELLE RANDALL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3320 OLD JEFFERSON RD BLDG 800, ATHENS, GA 30607-1400
(706) 353-2990
(706) 353-2992
Mailing address
3320 OLD JEFFERSON RD BLDG 800, ATHENS, GA 30607-1400
(706) 353-2990
(706) 353-2992
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/16/2024
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