Individual
RENEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Mailing address
21055 175TH ST, TONGANOXIE, KS 66086-5365
(913) 682-5118
(913) 682-4664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1921
KS
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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