Individual
BETH A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4175 LAKESIDE DR, RICHMOND, CA 94806-5774
(510) 262-6551
Mailing address
2075 CLARK ST, HERCULES, CA 94547-5498
(541) 961-1847
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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