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Individual

MS. OLINKA LASHAE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3711 RUPP DR STE 200, FORT WAYNE, IN 46815-4523
(260) 484-4600
(260) 848-4002
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9058
(419) 695-8010
(606) 328-5153

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34010969A
LCSW
IN
Enumeration date
08/13/2019
Last updated
03/05/2024
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