Individual
MS. ELAINE RUTHERFORD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 VILLAGE GREEN PKWY STE 4, BRADENTON, FL 34209-3401
(941) 795-7025
(941) 795-1480
Mailing address
501 VILLAGE GREEN PKWY STE 4, BRADENTON, FL 34209-3401
(941) 795-7025
(941) 795-1480
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW0003279
FL
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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