Individual
TANEASHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1629 K ST NW STE 300, WASHINGTON, DC 20006-1631
(202) 660-9770
Mailing address
4619 MANNASOTA AVE, BALTIMORE, MD 21206-5716
(443) 635-3000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
29463
MD
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
03/21/2025
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