Most Relevant Information
Provider Data
| NPI Number: | 1003466947 |
| Provider Name: | EVA-SOPHIA CLARK MA, LCSW, LCDC, EMDR |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 66542 |
Most Important Dates
| Enumeration Date: | 09/12/2019 |
| Last Updated: | 03/21/2021 |
Provider Practice Location
501 S CARROLL BLVD STE 203
DENTON
TX
762017423
Practice Location Phone/Fax
| Phone: | 6822999406 |
| Fax: |
Provider Mailing Location
12650 N BEACH ST STE 114
FORT WORTH
TX
762444245
Provider Mailing Phone/Fax
| Phone: | 6822999406 |
| Fax: |