Individual
GINA MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACSW
Contact information
Practice address
1008 W AVENUE J10, LANCASTER, CA 93534-4828
(661) 341-3900
Mailing address
1008 W AVENUE J10, LANCASTER, CA 93534-4828
(661) 341-3900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
29038
CA
Other
Enumeration date
02/05/2009
Last updated
05/31/2011
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