Individual
MS. CONNETRA LASHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 SE 4TH ST, 42, GAINESVILLE, FL 32641-8791
(352) 642-4775
Mailing address
1900 SE 4TH ST, 42, GAINESVILLE, FL 32641-8791
(352) 642-4775
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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