Individual
CAROLINE LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
31 HEATH ST, JAMAICA PLAIN, MA 02130-1650
(617) 523-6400
Mailing address
4 RINDGE TER, CAMBRIDGE, MA 02140-1826
(617) 460-5394
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2273680
MA
Other
Enumeration date
12/28/2011
Last updated
01/11/2017
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