Mary Clark, LICSW

NPI 1659468437 · on the registry since 2006

Practice

Address: 6401 University Ave Ne
Suite 304 Bhsi Llc
Fridley, MN 55432
Phone: (651) 769-6250
Fax: (651) 769-6299
Organisation at this address: Fairview Express Care
Columbia Park Medical Group, Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 27

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota