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Individual

MRS. ELIZABETH CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
903 W MARTIN ST, SAN ANTONIO, TX 78207-0903
(210) 358-3730
Mailing address
7703 FLOYD CURL DR, MAILING CODE 7792, SAN ANTONIO, TX 78229-3901

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
000966
MO
1041C0700X
Clinical Social Worker
Primary
57178
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
350211401
TX
01
350211402
CSHCN
TX
Enumeration date
08/25/2015
Last updated
11/11/2015
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