Individual
CHARLTON CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2864 S CIRCLE DR, COLORADO SPRINGS, CO 80906-4114
(719) 572-6100
Mailing address
220 RUSKIN DR, COLORADO SPRINGS, CO 80910-2522
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6030
CO
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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