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Individual

MRS. SANDRA DENICE CLARK

Active
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Individual

MRS. SANDRA DENICE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.S

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0804
MS
101YM0800X
Mental Health Counselor
LH0061
MS
101YP2500X
Professional Counselor
Primary
0804
MS
101YS0200X
School Counselor
168226
MS

Other

Enumeration date
08/30/2010
Last updated
08/31/2010
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