Individual
ABIGAIL O CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 N BENJAMIN LN, BOISE, ID 83704-9623
(208) 322-1026
Mailing address
759 S DEPEW ST, LAKEWOOD, CO 80226-4859
(714) 803-8246
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-45007
ID
Other
Enumeration date
03/06/2023
Last updated
09/09/2025
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