Individual
CHERIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
9111 HAVERSTICK RD, INDIANAPOLIS, IN 46240-1353
(317) 575-6500
(317) 575-6501
Mailing address
9111 HAVERSTICK RD, INDIANAPOLIS, IN 46240-1353
(317) 575-6500
(317) 575-6501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000122A
IN
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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