Individual
KRISTINA M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
511 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 525-7851
(304) 525-1073
Mailing address
99 CRACKER BARREL DR STE 100, BARBOURSVILLE, WV 25504-1650
(304) 525-7851
(304) 525-1073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2398
WV
Other
Enumeration date
03/13/2019
Last updated
09/05/2024
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