Gregory Clark's National Provider Identifier (NPI) Details
Gregory Clark, LCSW-R
NPI: 1558449843
Enumeration Date: 2006-11-02
Last updated: 2007-07-08
Sole Proprietor: YES
Status: active
Postal Address: 2608 ROUTE 305, CUBA, NY
Phone: 585-968-3816
Primary Practice Address: 2656 W STATE ST, SUITE 506, OLEAN, NY
Practice's phone: 716-378-1002