MR. Brandon W. Clark, LCSW

NPI #1932561115 in Lewiston, Idaho

Provider Information

NPI Number: 1932561115
Entity Type: Individual
Name: MR. Brandon W. Clark, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Mar 25, 2016
Last Updated: Oct 14, 2021

Practice Location

Address: 0309 2ND ST
City: Lewiston
State: Idaho
ZIP Code: 83501-2163
Phone: (208) 717-4453

Specialties & Taxonomy Codes

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

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