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1730530957
KELLY A CLARK
CASPER, WY
NPI
1730530957
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WY LCSW-1007)
Enumeration Date
2016-06-29
Last Update Date
2016-06-29
Business Address
-- KELLY A CLARK LCSW
1430 WILKINS CIR
CASPER, WY 82601-1336
Phone number: 307-237-9583
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Mailing Address
-- KELLY A CLARK LCSW
1430 WILKINS CIR
CASPER, WY 82601-1336
Phone number: 307-237-9583
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