Casandra Jewel Clark

NPI #1902231210 in Cottage Grove, Minnesota

Provider Information

NPI Number: 1902231210
Entity Type: Individual
Name: Casandra Jewel Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 5, 2013
Last Updated: Sep 16, 2022

Practice Location

Address: 8682 INWOOD AVE S
City: Cottage Grove
State: Minnesota
ZIP Code: 55016-4716
Phone: (651) 341-9660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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