Individual
JOSEPH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TCADC
Contact information
Practice address
130 HOPE ST, MT WASHINGTON, KY 40047-7772
(502) 904-9217
(502) 904-0856
Mailing address
130 HOPE ST, MT WASHINGTON, KY 40047-7772
(502) 762-8488
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
287091
KY
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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