Individual
JEAN K CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
MANHATTAN COUNSELING CENTER, 4751 MANHATTAN DR, ROCKFORD, IL 61108-2264
(815) 720-4960
(815) 720-4970
Mailing address
526 W STATE STREET, ROCKFORD, IL 61101-1214
(815) 968-9300
(815) 968-5314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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