Individual
ANGELA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1109 BURMAN DR, JACKSONVILLE, AR 72076-4386
(501) 982-7515
Mailing address
3601 RICHARDS RD, NORTH LITTLE ROCK, AR 72117-2954
(501) 221-1843
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A1510140
AR
101YP2500X
Professional Counselor
Primary
P1804053
AR
Other
Enumeration date
11/24/2015
Last updated
05/08/2018
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