Individual
DEBORAH CLARK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3460 BROADWAY ST, BOULDER, CO 80304-1824
(303) 441-1023
Mailing address
219 BOWEN ST, LONGMONT, CO 80501-5803
(303) 441-1023
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
07/31/2017
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