Individual
RENE THERESA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 RIVER ST, MATTAPAN, MA 02126-2729
(617) 981-9244
Mailing address
75 N BEACON ST, WATERTOWN, MA 02472-2671
(617) 661-3991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
187893081
MA
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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