Wooldridge, Clark E

Wooldridge, Clark E is an individual health care provider with primary practice located at 1220 Mitchell , Clovis NM 88101. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wooldridge, Clark E can be contacted via phone (806) 681-6745.

Contact Information

Primary practice address
1220 Mitchell Clovis NM 88101
Fax: (505) 742-3182
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I2267 New Mexico
Behavioral Health & Social Service Providers / Clinical 1041C0700X 05339 Texas

Profile Details

NPI number 1649380502
LBN Legal business name Wooldridge, Clark E
Credentials LISW ACP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649380502 NPPES
New Mexico MEDICAID 97107

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