Individual
BENJAMIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
(618) 345-9536
Mailing address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
(618) 345-9536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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