Individual
MS. MARTHA VELLANIRA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCSW
Contact information
Practice address
455 ACOMA ST, DENVER, CO 80204-5112
(303) 780-9191
(303) 780-9192
Mailing address
12850 JERSEY CT, THORNTON, CO 80602-9193
(303) 320-3790
(303) 320-4290
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW1466
CO
104100000X
Social Worker
LSW-339
CO
Other
Enumeration date
07/17/2008
Last updated
04/23/2010
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