Individual
M CLARK CANINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LMHC NCC
Contact information
Practice address
2281 LEE RD, SUITE 206, WINTER PARK, FL 32789-7203
(407) 647-4902
Mailing address
2281 LEE RD, SUITE 206, WINTER PARK, FL 32789-7203
(407) 647-4902
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH 6630
FL
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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