Individual
MRS. DEBORAH A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1500 LADY ST, COLUMBIA, SC 29201-3402
(803) 779-1995
(803) 779-7881
Mailing address
1500 LADY ST, COLUMBIA, SC 29201-3402
(803) 779-1995
(803) 779-7881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4166
SC
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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