Individual
KIMBERLY E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
110 MEDICAL CENTER DR, CLANTON, AL 35045-2332
(205) 651-0077
Mailing address
PO BOX 689, CALERA, AL 35040-0689
(205) 651-0077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
5455C
AL
Other
Enumeration date
04/26/2019
Last updated
10/25/2023
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