Wallace Clark IV, THERAPEUTIC MENTOR

NPI #1942667944 in Haverhill, Massachusetts

Provider Information

NPI Number
1942667944
Entity Type
Individual
Name
Wallace Clark IV, THERAPEUTIC MENTOR
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Social Worker
Credential
THERAPEUTIC MENTOR
Enumeration Date
Jan 21, 2016
Last Updated
Jan 21, 2016

Practice Location

Address
6 CONCORDIA DR
ZIP Code
01830-2062
Phone
(978) 373-3086

Specialties & Taxonomy Codes

Specialty
Social Worker

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