Individual
MRS. PATRICIA R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LMFT
Contact information
Practice address
186 KETTLE POND DR, WAKEFIELD, RI 02879-5419
(401) 789-7770
(401) 783-3636
Mailing address
186 KETTLE POND DR, WAKEFIELD, RI 02879-5419
(401) 789-7770
(401) 783-3636
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
51
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7221-2
BLUE CROSS & BLUE SHIELD
RI
Enumeration date
02/19/2007
Last updated
07/08/2007
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