Individual
SUSAN MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
300 TREEMONTE DR, ORANGE CITY, FL 32763-7977
(800) 614-4124
(888) 217-4124
Mailing address
674 CORAL WAY, WINTER SPRINGS, FL 32708-3127
(334) 220-2985
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11007813
FL
Other
Enumeration date
07/09/2020
Last updated
02/27/2024
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