Kelly Anne Clark

NPI #1073083788 in Vestal, New York

Provider Information

NPI Number: 1073083788
Entity Type: Individual
Name: Kelly Anne Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Enumeration Date: Nov 26, 2018
Last Updated: Nov 26, 2018

Practice Location

Address: 1715 CASTLE GARDENS RD
City: Vestal
State: New York
ZIP Code: 13850-1175
Phone: (607) 341-7017

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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