Individual
MR. ERIC DELANCEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 SOUTHERN AVE, BOSTON, MA 02124-2012
(617) 708-0870
(617) 516-8274
Mailing address
12 SOUTHERN AVE, BOSTON, MA 02124-2012
(617) 708-0870
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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