Individual
JAELA NICOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6285
(706) 733-0188
Mailing address
1439 COLLINS DR, AUGUSTA, GA 30907-9769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW012690
GA
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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