Individual
REBECCA ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D, LCSW
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(270) 535-2545
Mailing address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(270) 535-2545
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1151-3714C
AL
1041C0700X
Clinical Social Worker
Primary
CSW007735
GA
Other
Enumeration date
09/28/2012
Last updated
02/29/2024
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