Individual
STACEY L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
493 WESTFIELD RD, B, NOBLESVILLE, IN 46060-1327
(317) 776-3730
(317) 770-5424
Mailing address
PO BOX 1258, ANDERSON, IN 46015-1258
(765) 649-8161
(765) 641-8238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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