Individual
DIANA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 1/2 W JACKSON ST, HUGO, OK 74743-5655
(580) 326-9475
Mailing address
PO BOX 831, HUGO, OK 74743-0831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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