Individual
MS. ANGELA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LICSWA, MCA,SUDP
Contact information
Practice address
317 N. PINES, SPOKANE, WA 99206
(509) 838-4651
(509) 326-5025
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC61249881
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60656762
WA
104100000X
Social Worker
Primary
SC60656780
WA
Other
Enumeration date
11/27/2018
Last updated
01/17/2022
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