Individual
AMANDA KAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 FAIRMONT ST, SALMON, ID 83467-3932
(801) 833-8767
Mailing address
207 FAIRMONT ST, SALMON, ID 83467-3932
(801) 833-8767
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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