Individual
AMY PATRICE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 WALLINGWOOD DR, BUILDING 1 SUITE 208, AUSTIN, TX 78746
(512) 975-3233
Mailing address
1212 COUNTRY RD, BLANCO, TX 78606-5281
(512) 975-3233
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
71649
TX
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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