Individual
TIERRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8507 MAIN ST, ELLICOTT CITY, MD 21043-4997
(443) 527-2785
Mailing address
330 SAINT PAUL ST APT 5, BALTIMORE, MD 21202-4989
(443) 527-2785
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
Primary
24554
MD
Other
Enumeration date
04/27/2016
Last updated
01/12/2022
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