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1124594742
PAUL EDWARD CLARK
HAMPTON, VA
NPI
1124594742
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904010740)
Enumeration Date
2018-10-22
Last Update Date
2018-10-22
Business Address
PAUL EDWARD CLARK LCSW
100 EMANCIPATION DR
HAMPTON, VA 23667-0001
Phone number: 757-722-9961
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Mailing Address
PAUL EDWARD CLARK LCSW
132 LIGHTHOUSE DR
PORTSMOUTH, VA 23703-5473
Phone number: 757-434-5211
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