Individual
VICKI LYNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
(440) 285-4552
Mailing address
7068 CONSTANTINE CT, MENTOR, OH 44060-5124
(440) 942-6135
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E 0002811
OH
101YM0800X
Mental Health Counselor
E 0002811
OH
Other
Enumeration date
11/27/2006
Last updated
09/11/2025
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