Individual
MRS. DANA MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 N CLARENCE NASH BLVD, WATONGA, OK 73772-3636
(580) 623-5433
Mailing address
1300 E QUAIL AVE, APT 1, WEATHERFORD, OK 73096-2534
(405) 623-8910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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