Individual
NICOLE RENAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
48 MEDICAL PARK DR E, BIRMINGHAM, AL 35235-3400
(205) 517-7730
Mailing address
600 27TH AVE NW, CENTER POINT, AL 35215-2216
(205) 482-2739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3619C
AL
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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