Individual
MS. SANDRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LMHC
Contact information
Practice address
205 N COLLEGE AVENUE, SUITE 210A, BLOOMINGTON, IN 47404
(812) 334-1324
Mailing address
205 N COLLEGE AVENUE, SUITE 210A, BLOOMINGTON, IN 47404
(812) 334-1324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000552A
IN
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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