Individual
HEATHER JEAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
43 VILLAGE OF STONEY RUN APT F, MAPLE SHADE, NJ 08052-2143
(609) 617-4604
Mailing address
43 VILLAGE OF STONEY RUN APT F, MAPLE SHADE, NJ 08052-2143
(609) 617-4604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC014131
PA
Other
Enumeration date
05/24/2022
Last updated
07/19/2024
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