Individual
AIMEE LYNNELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS CADCI
Contact information
Practice address
3031 NE STEPHENS ST, ROSEBURG, OR 97470-6237
(541) 229-7038
Mailing address
PO BOX 1700, ROSEBURG, OR 97470-0414
(541) 229-7038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-08-21U
OR
101YM0800X
Mental Health Counselor
Primary
R8950
OR
Other
Enumeration date
03/01/2016
Last updated
04/14/2026
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