| Doctor Name: | WILLIAM PETER CLARK |
| NPI Number: | 1093065237 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 673 |
| Business Practice Address: | 830 Lincoln St Lander, WY - 825202736 |
| Business Phone Number: | 3073329577 |
| Business Fax Number: | 3073323106 |
| Mailing Address: | 830 Lincoln St, LANDER |
| State: | WY |
| Postal Code: | 825202736 |
| Phone Number: | 3073329577 |
| Fax Number: | 3073323106 |
| NPI Enumeration Date: | 09/14/2012 |
| NPI Last Update Date: | 09/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 673 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |