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Individual

LISA F CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 523-2005
(606) 523-9704
Mailing address
PO BOX 1150, BARBOURVILLE, KY 40906-5150
(606) 546-9287
(606) 546-0009

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
247004
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100128550
KY
Enumeration date
01/21/2009
Last updated
03/12/2019
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