Individual
GEORGE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
105 MERRICK ST, WORCESTER, MA 01609-1937
(508) 797-6100
(508) 797-0693
Mailing address
10 MECHANIC ST STE 302, WORCESTER, MA 01608-2419
(508) 792-5400
(508) 831-0074
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
112041
MA
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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