Individual
TERRI CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 NE 63RD ST, OKLAHOMA CITY, OK 73105-1421
(405) 371-2506
Mailing address
21 NE 63RD ST, OKLAHOMA CITY, OK 73105-1421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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