Individual
MS. SAMANTHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3117 1ST AVE SE STE A, CEDAR RAPIDS, IA 52402-4403
(319) 961-2609
(319) 365-0899
Mailing address
7717 N ORANGE PRAIRIE RD, PEORIA, IL 61615-9323
(309) 589-6800
(309) 589-6973
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.018675
IL
Other
Enumeration date
12/23/2015
Last updated
08/25/2023
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