Individual
MRS. ANITA COLEEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 IMMANUAL ST, NASHVILLE, AR 71852-3937
(870) 845-3262
Mailing address
755 ACADEMY RD, NASHVILLE, AR 71852-8221
(870) 557-6629
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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