Individual
LATASHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 SW 44TH ST STE 500, OKLAHOMA CITY, OK 73109-3615
(405) 605-4249
Mailing address
7617 S HIWASSEE RD, OKLAHOMA CITY, OK 73150-7324
(405) 550-9473
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCCANDIDATE12934
OK
Other
Enumeration date
01/03/2024
Last updated
02/03/2026
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