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Individual

BRITTANY JOYELL CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSW

Contact information

Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-2255
Mailing address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-2255

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16-6002567
NY
Enumeration date
08/30/2018
Last updated
08/30/2018
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