Individual
TRESVANT LLEWELLYN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 FAISON DR, COLUMBIA, SC 29203-3210
(803) 935-6742
Mailing address
115 DEER HOUND TRL, COLUMBIA, SC 29223-2815
(803) 935-6742
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16627
SC
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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