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Individual
SHEILA A CLARK
Active
Individual
SHEILA A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401015688
MI
101YP2500X
Professional Counselor
6401015688
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6401015688
—
MI
Enumeration date
03/04/2019
Last updated
03/04/2019
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