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Individual

L CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
405 CREEKSTONE RDG, WOODSTOCK, GA 30188-3746
(770) 233-7580
Mailing address
5101 OLD HIGHWAY 5 UNIT 503, LEBANON, GA 30146-0817

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YP2500X
Professional Counselor

Other

Enumeration date
01/28/2007
Last updated
03/17/2023
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