Individual
DR. GRACE D. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11205 LAKE VICTORIA LN, BOWIE, MD 20720-4262
(301) 809-6310
Mailing address
11205 LAKE VICTORIA LN, BOWIE, MD 20720-4262
(301) 809-6310
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
CL 73048
FL
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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