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Individual

BENJAMIN A CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1028 WALNUT ST, YANKTON, SD 57078-2910
(605) 665-4606
Mailing address
1310 W 30TH ST, YANKTON, SD 57078-5385

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8512
SD

Other

Enumeration date
09/27/2021
Last updated
09/27/2021
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