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1598363665
TINA M CLARK
SHAWNEE, KS
NPI
1598363665
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: KS 3663)
Enumeration Date
2020-10-12
Last Update Date
2020-10-12
Business Address
TINA M CLARK LSCSW
7150 MILLBROOK ST
SHAWNEE, KS 66218-9235
Phone number: 913-522-8548
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Mailing Address
TINA M CLARK LSCSW
7150 MILLBROOK ST
SHAWNEE, KS 66218-9235
Phone number: 913-522-8548
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