Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW135679 | PA |
NPI | 1003581836 |
---|---|
Provider Name | April Clark |
First Address | East Stroudsburg, PA 18301-2101 |
Second Address | Easton, PA 18045-7820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |