Individual
HENRY WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
409 VANDIVER WEST BLDG 6, SUITE 102A, GREAT CIRCLE, COLUMBIA, MO 65202
(573) 442-8331
Mailing address
1709 OAKWOOD CT, COLUMBIA, MO 65203-1704
(573) 864-4600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002440
MO
Other
Enumeration date
06/14/2017
Last updated
12/18/2020
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