Individual
MS. JULIE KATHLEEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC, CRC, MITS
Contact information
Practice address
220 BAY ST, PETOSKEY, MI 49770-2473
(231) 622-5061
Mailing address
220 BAY STREET, PETOSKEY, MI 49770
(231) 622-5061
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011220
MI
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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