Individual
BETH S CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 CONGRESS ST, #7736, PORTLAND, ME 04112-3500
(207) 274-3928
Mailing address
PO BOX 7736, PORTLAND, ME 04112-7736
(207) 274-3928
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC16354
ME
Other
Enumeration date
03/12/2015
Last updated
12/10/2016
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