Individual
MS. LAURA L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCAS
Contact information
Practice address
429 BILLINGSLEY ROAD 2ND FLOOR, MECKLENBURG COUNTY SUBSTANCE ABUSE SERVICES CENTER, CHARLOTTE, NC 28211-1098
(704) 432-0321
Mailing address
557 MELBOURNE CT, CHARLOTTE, NC 28209-1826
(704) 665-8564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111895
—
NC
Enumeration date
01/25/2007
Last updated
07/08/2007
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