Individual
MARYBETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
206 W 5TH ST, METROPOLIS, IL 62960-1810
(618) 524-9368
(618) 524-9368
Mailing address
206 W 5TH ST, METROPOLIS, IL 62960-1810
(618) 524-9368
(618) 524-9368
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
275760
KY
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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