Individual
SAMANTHA D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 335-0863
Mailing address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 926-1171
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000010976
TN
Other
Enumeration date
12/20/2018
Last updated
03/18/2019
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