Individual
CYNTHIA ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-0007071
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000489716
ANTHEM BCBS
OH
01
—
I 0007071
STATE LICENSE
OH
Enumeration date
07/17/2006
Last updated
07/08/2007
Update your record
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