Individual
ANDREA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 SOUTHARD ST, TRENTON, NJ 08609-1020
(609) 396-4557
Mailing address
10 SOUTHARD ST, TRENTON, NJ 08609-1020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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