Individual
LATONIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Mailing address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
844
KS
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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