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Individual
ERIC VINCESON CLARK SR.
Active
Individual
ERIC VINCESON CLARK SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/13/2017
Last updated
06/26/2023
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