Individual
ELIZABETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 OXFORD ST, SOMERVILLE, MA 02143-1608
(508) 982-2310
Mailing address
52 OXFORD ST, SOMERVILLE, MA 02143-1608
(508) 982-2310
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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