Individual
TAMIKA SHANTAI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1330 MCCORMICK DR., LARGO, MD 20774
(301) 772-1200
Mailing address
9614 GRANDHAVEN AVE, UPPER MARLBORO, MD 20772-5268
(301) 938-6927
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
G13108
MD
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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