| Doctor Name: | TAMMY DENTON CLARK |
| NPI Number: | 1700911526 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 878 |
| Business Practice Address: | 1016 Mt Highway 200 Noxon, MT - 598539745 |
| Business Phone Number: | 4062530864 |
| Business Fax Number: | |
| Mailing Address: | Po Box 185, HERON |
| State: | MT |
| Postal Code: | 598440185 |
| Phone Number: | 4062530864 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2007 |
| NPI Last Update Date: | 10/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 878 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |