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1811677172
BRAD CLARK
PORTLAND, ME
NPI
1811677172
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ME MC22300)
Enumeration Date
2023-07-21
Last Update Date
2023-07-21
Business Address
BRAD CLARK
216 VAUGHAN ST
PORTLAND, ME 04102-3204
Phone number: 207-662-2469
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Mailing Address
BRAD CLARK
216 VAUGHAN ST
PORTLAND, ME 04102-3204
Phone number: 207-662-2469
Copy
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