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Individual

JAMES CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MCP, BHRS

Contact information

Practice address
1625 W GARRIOTT RD STE F, ENID, OK 73703-5653
(580) 242-4673
Mailing address
1625 W GARRIOTT RD STE F, ENID, OK 73703-5653
(580) 242-4673

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/25/2010
Last updated
01/25/2010
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