Tierra Clark LMSW - Social Worker in Ellicott City, Maryland | ProviderWire

Full Name

Tierra Clark LMSW

NPI Number

1811342868

NPI Type

Individual Provider

Gender

Female

Enumeration Date

04/27/2016

Specialties

(Taxonomies)

Name

Behavioral Analyst

Code

104100000X

103K00000X

Primary Taxonomy

Yes

No

Licenses

State

Maryland

License Number

24554

Contact
Information

Purpose

Mailing

Location

Address

330 SAINT PAUL ST APT 5

8507 MAIN ST

City

Baltimore

Ellicott City

State

MD

MD

Postal Code

21202-4989

21043-4997

Country

US

US

Telephone Number

(443) 527-2785

(443) 527-2785

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/12/2022

Provider Address

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