Individual
MS. AMY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
102 MARTY DR, BUFFALO, MN 55313-9305
(763) 682-5420
(763) 682-5803
Mailing address
3226 GARFIELD ST NE, MINNEAPOLIS, MN 55418-2226
(612) 816-2361
(612) 788-9505
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1340
MN
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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