Provider Information for 1538342530
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REBECCA CLOCK LCSW, LICSW
Sex: Female
NPI: 1538342530
Last Updated: 2025-01-03
Certification Date: 2025-01-03
Certification Date: 2025-01-03
Details
| Name | Value | ||||||||||||||||
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| NPI | 1538342530 | ||||||||||||||||
| Enumeration Date | 2007-12-12 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 550 W B ST FL 4 SAN DIEGO, CA 92101-3537 United States Phone: 253-843-7851 | Fax: | ||||||||||||||||
| Primary Practice Address | 4223 69TH STREET CT GIG HARBOR, WA 98335-8386 United States Phone: 617-308-2384 | Fax: | ||||||||||||||||
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