Individual
MARY WATSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LMSW
Contact information
Practice address
410 CHURCH ST SE, MINNEAPOLIS, MN 55455-0222
(612) 625-8400
(612) 677-3211
Mailing address
410 CHURCH ST SE, MINNEAPOLIS, MN 55455-0222
(612) 625-8400
(612) 677-3211
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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