Organization
INTEGRATIVE COUNSELING AND ART THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORI CLARK LPC (OWNER)
(503) 997-0024
Entity
Organization
Contact information
Practice address
1724 VINE ST, DENVER, CO 80206-1120
(503) 997-0024
Mailing address
9374 ALANGO RD, ANGORA, MN 55703-4701
(503) 997-0024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/05/2018
Last updated
01/06/2024
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