Most Relevant Information
Provider Data
| NPI Number: | 1003458068 |
| Provider Name: | ANADDIA S CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/11/2019 |
| Last Updated: | 10/11/2019 |
Provider Practice Location
4929 W FOND DU LAC AVEUNE
MILWAUKEE
WI
532162324
Practice Location Phone/Fax
| Phone: | 4148716122 |
| Fax: | 4148712552 |
Provider Mailing Location
4929 W FOND DU LAC AVEUNE
MILWAUKEE
WI
532162324
Provider Mailing Phone/Fax
| Phone: | 4148716122 |
| Fax: | 4148712552 |