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1477154805
REGINA COLLETTE CLARK
CLARKSVILLE, TN
NPI
1477154805
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TN 12746)
Enumeration Date
2020-11-03
Last Update Date
2020-11-03
Business Address
Mrs. REGINA COLLETTE CLARK LMSW
1989 MADISON ST
CLARKSVILLE, TN 37043-5067
Phone number: 931-408-9909
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Mailing Address
Mrs. REGINA COLLETTE CLARK LMSW
202 EAGLES TALON CT
CLARKSVILLE, TN 37040-1481
Phone number: 706-664-7601
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