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Individual
MR. SAMUEL P. CLARK
Active
Individual
MR. SAMUEL P. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMH
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MH820
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH820
FL
101YM0800X
Mental Health Counselor
Primary
MH820
FL
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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