Individual
JENNIFER R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
208 STATE STREET, HOOD RIVER, OR 97031-9734
(541) 429-1064
Mailing address
830 COUNTRY CLUB RD, HOOD RIVER, OR 97031-9734
(541) 429-1064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
L3395
OR
1041C0700X
Clinical Social Worker
Primary
L3395
OR
Other
Enumeration date
01/25/2007
Last updated
08/01/2023
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