Individual
MIRANDA PAIGE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6066 CEDAR HILL LN, FLORENCE, KY 41042-1046
(513) 257-9064
Mailing address
6066 CEDAR HILL LN, FLORENCE, KY 41042-1046
(513) 257-9064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
274268
KY
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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