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Individual

GLORIA CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
1300 S DUNCAN DR, BUILDING E, TAVARES, FL 32778-4223
(352) 343-0752
(352) 315-7587
Mailing address
1300 S DUNCAN DR, BUILDING E, TAVARES, FL 32778-4223
(352) 343-0752
(352) 315-7587

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH 13844
FL

Other

Enumeration date
12/01/2015
Last updated
12/01/2015
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