Individual
MARY EGAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCGC
Contact information
Practice address
3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4395
(267) 425-3154
(267) 425-0007
Mailing address
3501 CIVIC CENTER BLVD, COLKET #3019, PHILADELPHIA, PA 19104
(267) 425-3154
(267) 425-0007
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000886
PA
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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