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1104196815
KELLI MARIE CLARK
MASSENA, NY
NPI
1104196815
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: NY R054044-1)
Enumeration Date
2012-01-11
Last Update Date
2018-04-24
Business Address
KELLI MARIE CLARK
23 MAPLE ST
MASSENA, NY 13662-1017
Phone number: 315-769-8441
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Mailing Address
KELLI MARIE CLARK
23 MAPLE ST
MASSENA, NY 13662-1017
Phone number:
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