Individual
ANTHONY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3369 ESQUARRE CT, WOODBRIDGE, VA 22193-1026
(571) 205-0344
Mailing address
3369 ESQUARRE CT, WOODBRIDGE, VA 22193-1026
(571) 205-0344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904007949
VA
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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