Individual
MARY WATSON CLARK
Active
Individual
MARY WATSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801066900
MI
1041C0700X
Clinical Social Worker
Primary
21255
MN
1041C0700X
Clinical Social Worker
6801066900
MI
Other
Enumeration date
02/05/2007
Last updated
12/30/2025
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