Individual
MRS. ANGELA JOHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LPCC, NCC
Contact information
Practice address
673 S AUBURN ST, GRASS VALLEY, CA 95945-7576
(530) 913-7221
Mailing address
3121 SWEETWATER SPRINGS BLVD APT 78, SPRING VALLEY, CA 91978-1530
(816) 548-7673
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
13646
CA
101YP2500X
Professional Counselor
2017043804
MO
Other
Enumeration date
01/18/2018
Last updated
06/01/2023
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